Methadone conversion calculations cannot be bidirectional because the half-life of methadone is long, approximately 15-60 hours. Methadone therefore stays in the body for several days after discontinuation. In essence, after calculating a conversion to morphine (or equivalent), one cannot simply stop the methadone and substitute with the equivalent dose because both drugs will remain in the body. Careful slow titration and transition to or from methadone is vital.

If the clinician can get past all these barriers, we are often left with the daunting task of converting other opioids to an equivalent dose of methadone. Online opioid conversion calculators have been shown to vary in methadone calculation by up to 242% (Presented by Dr. Kathryn C. Shaw, Eastern States Residency Conference, Hershey PA; May 2012), which could easily be fatal. In fact, methadone accounts for 2% of all opioids prescribed in the U.S., yet 33% of all opioid-related deaths from overdose involve methadone. When a healthcare practitioner transitions a patient to methadone, a potential disparity in calculated dose conversions is in large part due to varying methadone conversion schematics that have heretofore by some, been considered acceptable standards. These were suggested by Ripamonti(1998), Ayonrinde(2000), and Mercadente(2001). Fourteen years have passed since Ripamonti’s original proposed schematic, yet until now, nobody has graphed the three strategies against one another to show the irrationality in terms of peaks and troughs over several hundred milligrams.

Graphing these schematics spurred my initiative to develop a formula that would smooth out the methadone conversion curve. Hence, the Fudin Factor, a methadone conversion equation (Copyright, 2011) was derived.

Methadone Schematics Graphed Against Fudin Factor

A feature article appears in the September 2012 issue of Practical Pain Management that details the equation. Click on “Mathematical Model for Methadone Conversion Examined” to read about the history of methadone, view a comparison of previously accepted schematics outlined herein, and learn about the derivation of the FUDIN FACTOR, inherent limitations, and how it compares to Ripamonti, Ayonrinde, and Mercadente.

AS ALWAYS, YOUR THOUGHTFUL COMMENTS (PRO OR CON) BELOW ARE WELCOMED, ENCOURAGED, AND MET WITH ENTHUSIASM!

496 thoughts on “Methadone Dose Conversion Unscrambled”

I’m really glad I came across this blog. This is the most information I’ve found on Methadone in one place. Thank You for all this info!

I have been on Methadone for the past two years. I had a ugly oxy habit that morphed into heroine. I had to stop. Thank God I found Methadone. It’s saved my life. Now I’m clean and dosing down so I can live a drug free, happy life. I went up to 110 mg once a day. I’ve been going down by 5mg every week and now I’m at 45 mg. I dose down on Fridays so if I do suffer any withdraw symptoms it’ll be thru the weekend (or so I hope anyway) so it won’t affect my job.

I don’t know if this is normal but I swear I haven’t had a single bad feeling this entire time. They keep scaring me at the clinic because they keep telling me it’s going to hit me super hard and I better brace for the coming pain. IDK why they keep doing that, seems they would be encouraging me to keep up the good work instead of scaring me to death. Here’s the thing tho, like I said, I had a ugly habit and I know my way around withdraws! If I do experience anything from coming off the methadone then so be it. I don’t want to go thru that, but if I have to then oh well.

My question is, Do you think I’ll continue to be okay or do you think it’s going to hit me hard like they are saying?

At this rate I’ll be methadone free the second week in August. I don’t want to slow down. I will if it becomes really bad and I can’t handle it. I hope that won’t happen tho.

Hey i have been in your situatioin. Its going to hit you hard but only when you completely stop. Its going to be tolerable but deffinitly not fun. Grt gabapentin if you can and clonadine. You will most likely have to take a week off work

Lucky you. I’ve been on 90mg/day for 14 years. Started opiates after severe back injury. A few years ago I decided to taper down. At 87mg I was in unbearable withdrawals. Went back up to 90. I can’t miss a dose or even be 4 hours late before my stomach is in knots & withdrawals start. Methadone saved my life. I hate being on the borderline of disaster though. My last full blown withdrawals 14 years ago had me in the ER with kidney, urinary tract & bladder infection from dehydration. My liver test was very bad. Next it would have hit my heart. I have cardiomyopathy & certainly would have died. I haven’t touched an opiate in 14 years but the methadone has a drug addict stigma on it.
Good luck to you Jennifer. Sounds like your on the road to being free.
Joe

Methadone works on opiate receptors, blocks NMDA receptors, and blocks reuptake of norepinephrine and serotonin. Gabapentin is very different – it blocks voltage-gated calcium channels at the alpha-2-delta subunit recprtors. This may seem like another language, but you can see here that they are VERY different!

I have been on 37.5 mcg of fentanyl patches for over two years. Plus 10/350 hydrocodone 3 x daily as needed for breakthrough pain. My doctor wants to stop the fentanyl and put me on 5mg of methadone 3-4 times a day. Is this a correct conversion? I thought it was not and am concerned about withdrawal issues. Can you give me a general conversion rate from fentanyl to methadon e that I can understand. I am a male 200 lbs. 6’2″. Chronic kidney disease.

Conversions need to me done gradually by a experienced clinician, especially with methadone. There is no exact equivalent because each patient is different. Gnerally speaking though, the higher your opioid dose, the less methadone will be needed to replace it. I know that sounds counter-intuitive, but methadone has very unique pharmacokinetics which is why this is so tricky. My suggestions is to work closely with your doctor.

asking for a friend. Considering methadone. After researching, methadone seems like a good treatment Long term/chronic abuse of rx painkillers. Tried several different types of treatment before, last treatment was 7 months inpatient. Relapse after 3 months home. Patient tried Suboxone , which has worked before, for a little while. Patient went off suboxone, relapsed. No insurance or cash. Methadone is most cost effecient treatment available. Patient also has chronic pain and needs medication that will help quell pain. methadone seems like a great idea. what are the downsides of methadone? what advice can you give to someone about to begin methadone tx? thank you.

As you can see from the article, methadone is very complex. It has many advantages for pain over traditional opioids, but many more dangers and toxicities. The selection of methadone over other options is very patients specific, so I cannot safety provide you with advise one way or the other.

Hi Ive been on Methadone for the last 6 yrs, started at what is considered a low dose gradual increase til my pain was managed ( I had been on oxycotin 80mg 2x a day and then oxycodone for breakthrough pain 10mg 4x a day) However I have decreased my methadone dose down to 30mg I take 1.5 pills in morning and 1.5 in evening. I was always reluctant to go on it because of the stigma, however it has helped tremendously and now my pharmacist called my Dr and wanted to know why I was taking this( mind you my Dr called and asked if it was okay to give them this info?) I was like why does she need it, your the prescribing Dr? My Dr said that when they do the pre-auth they need the diagnosis codes ( Now there is a little reason I disnt want the pharmacistnto have this info because I happen to work at this grocery store , however now when I was talking to the pharmacy tech the other day about getting my money back( it didn’t go thru my insurance and it was do that day and then it was the weekend and I dont work weekends so I knew.I.would withdrawal so I paid for it) However I was informed at that time that they dont do pre-auths. Only for partnership health ( Medi-cal) which I.am not! My question is 1. Can the pharmacist deny.my medicine if my Dr doesnt.drop my dosage( which what she basically said) and 2. With all the guidelines my Dr said this is a.good dose for you, your able to work and continue on with a somewhat normal life! What do I do whan my.pharmacy is the only one who takes.my.insurance? Also what is 30mg a day equivalent to morphine? Thank you in advance. Out of pain for now? Melissa

My friend was taking heroine wanted to use methadone to come off the heriome he did,took 3 days worth of methadone and has stopped taking that since yesterday only used it 3 days,will his withdrawals be very bad?

Hi. I’m not a doctor but have been taking methadone for 10 years. It seem’s your friend may not be ready to quit his habit. It does work but you have to change everything around you , including friends who still use any anything else that can cause triggers. Addiction can be hard but a person can only quit if they want to. Also it seems expensive but $10 a day is nothing compared to a habit. Good luck I hope this helps

Hello, I have a horrible spinal disease called Arachnoiditis. Ive had 2 lumbar back surgeries and 1 cervical neck surgery. I have titanium rods and screws in my lower back which has caused horrible scoliosis, DDD, Spinal stenosis and the Arachnoiditis. This is a very rare yet wicked disease. My doctor my pain is comparable to someone with stage 5 camcer that is pretty much about to lose their life. It has a very high suicide rate and I am only 38 years old. Ive been going to a methadone clinic for 3 years now and I am on 170 mgs daily. Its only controlling my pain for about 4 to 5 hours a day. Ive finally found a pain management doctor who wants to put an interthecal pump in me but he wont touch me until I get down to 90 mgs of methadone. He told me he wanted me to titrate down 20gs a day until I get to 90. Of course the clinic doctor wouldnt agree to that. He is taking me down 10 mgs every 3 days until I get to 115 mgs then he is going to do 5 mgs a day. Im scared to death bc I know what methadone withdrawals can be like. Ive kicked it completely on my own before bit I was only on 80 mgs at that time. I tried going back to my last pain management doctor to be put on 5 mg Roxycodone. That was a joke so I had to go back to the methadone. Has anyone else had this horrible disease or heard of it and can anyone give me any advice please? I am to the point I am scared that i am getting suicidal bc the pain is so unbearable and I have 2 beautiful daughters and the most wonderful husband ever. They r the glue hding me together and my good lord above of course but im really scared. I need any positive advice I can get. Thank you very much!!!

Man I hope you truly don’t go down the methadone road. I am typing this after 13yrs of methadone prescription from a stupid ass dr. Who said shit here take this instead of those 10mg oxycodone. Your great President Bush even takes these. Me naive and dumb went home and told my wife about this new drug the great doctor was gonna have me on. We were happy that I would only be taking one pill. Yeah let me tell you what the truth is brother. Dr’s are being overseen now by the government and won’t be able to be able to hand out candy anymore without huge issues for them. So you will get a letter like I did that my doctor will no longer be able to write any narcotic drugs. Yeah man a fucking letter in the mail. I was days from being out when I received this letter also. The state I live in has a hard on for pain management Dr’s so I have no other local within a 2 hr ride to get meds. So I took my damn life back and closed my self in the house shut my phone off and waited. I took what came each day knowing that I was owning my life and the directions I wanted to go. No more Doctors each month and nerves of will they write the script in time for me to be off from work to go fill it blah blah blah. You know that ball and chain they have attached to you. Well I took mine off 7 days ago. I will tell everyone it can be done. Cold Turkey. It’s not a walk in the park but I have dealt with far worse pain for long periods. You get ready in your head that this is IT! You can do it. Promise!

Right on. My husband used a methadone clinic to get off opioids back in 2001 and said it was the worst thing he ever came off of. Said it was pure torture. He had come down off everything at one point or another when he finally decided to try the methadone clinic and he never touched an opioids after. He had opioids prescribed a few times over the years for surgery and the like even after letting the Dr know hey he has a drug problem. Dr. Just said oh it’s fine we’ll monitor you. That’s not how that works at all. Another 4 yrs of his life playing with the devil. I approached him and suggested (he heard “Threatened”) him with methadone and he was like no thanks, I’m done. And he was. He is a binge type user I guess. He has been clean 5 yrs now. That threat of methadone looming made him snap out of it again like no thanks. Also you can be on a “maintainance” dose of methadone forever. So long as your pee tests are right they don’t kick you off it at the methadone clinic. There were people at the clinic who had been on it for years and never had a plan to go off it.

During the recent crack down on opioids my reg Dr. Switched like all the patients to methadone because they weren’t getting any push back on it like they were other opioids. Over treating some and under treating others. That’s sad for those who need it. Pain is a very complex issue. In my eyes in our home I would rather be in pain every single day then watch addiction killing my husband. And watching my husband struggle made me scared to even try them. No thanks.

Glad you bit the bullet and came out the other side. Congrats on that. No matter how you did it, you did it!

I am currently taking 145mg of liquid methadone started at 30 mg. I just want to be off of the methadone but the doctor says itll take over a year to wean down the right way. But I want to go to a detox and just go through it. How bad would the withdrawls be and is it a wise thing to do if the detox place helps me get through it? I’ve been taking methadone for about 5 months.

Either approach can be done. There are rapid detox centers that can do it as an inpatient. Not all patients respond the same. There are also drugs that can be used to blunt the withdrawal such as clonidine or Lucymera.

Hello my name is Rachel. I just have a few short questions for you and would love to hear some insight on my current situation. So I was originally taking 120 milligrams of methadone for a little over a full year as medically advised before tapering down and have been properly dosing down every 7 to 10 days by 10 milligrams as required my the clinic that I attend each day and I am currently down to 40 milligrams as of this past Monday. I intend to go down another 10 milligrams next week so I will be down to 30 milligrams and from then I will go down by 2.5 milligrams every 7 to 10 days until I reach 10 milligrams. Surprisingly I have not felt any severe withdrawal symptoms as I had expected but as they say when you taper down properly you will not feel many symptoms. My question to you is that once I reach 10 milligrams per day at being at such a low dose if I took myself off if I felt okay after testing it out for a day even though I know that is against medical advice do you think I would have any serious withdrawal symptoms in doing so and have you known people to react badly in doing this? I have consulted my counselor at my clinic already about this and she has said that of course everyone’s metabolisms are different and even though I may not be feeling any withdrawal symptoms just yet it may hit me all at one time once I get down to that dose. In you professional experience have you known this to happen or are most people okay coming off at that milligram with not many symptoms? I know I am medically advised to go all the way down to 2.5 and come off completely from that dose but I’m just curious if it is possible to come off at 10 and feel okay since it is such a low dose from where I started at 120. Thanks and please respond at your earliest convenience.

Rachel, Your counselor is correct – methadone has very complex metabolism and the is huge variability from person to person with each metabolic enzyme involved. There doesn’t seem to be an emergency here and your clinic is on top of things. Why risk the potential to make yourself miserable if there’s no reason to rush?

Definitely DO NOT do a rapid detox!!! I did that back in early 2017, a 14-day detox & I was only on 40MG. I was in pure H*ll for an entire month. The first two weeks were absolutely unbearable. RLS all night long, making it impossible to sleep. Throwing up, diarrhea, the works. Anxiety through the roof. Sweating while being cold as heck. Cold to hot, hot to cold, cold to hot… & so on…. I was not myself for 4-5 weeks. It was something I hope I NEVER have to go through again. So definitely taper slowly. I now a whole entire year absolutely SUCKS to hear, but you’re going to thank yourself for tapering slowly! You will be okay, if you don’t want to do a full year, tell them that. A lot of Methadone doctors will try to scare you JUST to keep you on it. It’s crappy, but that’s what they do. Be strong! I hope Everything works out well for you, I wish you luck!!!
P.S. Sorry if this is a super late reply!

From personal experience, take the time to wean off slowly. I did it the hard way and was sick for at least three months after I left detox. I’m doing it the slow way now and I have t felt any withdrawals so far.

Methodone for 5 months will rewire your’e brain where you could have extreme highs and lows. I’ve been on it for 10 years for pain at 240 for over 9 of them. I’m at 10 milligrams and I’m starting to feel it more then I want to. I went down 10 a week till I got to 60 then 5 a week to 20. Then I went to 1 every other day. I’m gonna hold to get used to it. Everyone is different though. I had no triggers to relapse because it was pain management but that’s not a common thing. If you feel bad from lowering just hold to adjust but know that your brain is going to take time to adjust. I have been doing nothing but reading about methodone detox for last 2 weeks to try and make my detox easier and time and patience are the key. Hope this helps.

hello i just have one question. im on 15mg methadone now 3 weeks now, been slowly tapering from 30-40 mg. i have always felt withdrawl first thing in the morning. nothing severe just enough to notice. i am planning to switch to subozone , how long should i wait before taking first dose. i feel like 2 or 3 days is a little much for how low a dose i am on. after 24-30 hrs i am deffinetly im quite moderate w/d. just wonering your opinion. thanks again,

My name is Kayla. I have been on liquid methadone for pain management about 2 years. I started at 30mg and upped my dosage until I was stable enough to not feel withdrawals anymore. I am now at 115mg and I’ve been at this dose for 6 months. Here’s my issue. At 5am, after I medicate and the medicine kicks in, I start to feel tired and nod out; which tells me I may be at too high of a dose- all though at about 12pm, I literally feel like I haven’t even dosed, and I experience withdrawal like symptoms!! Fever, chills, yawning… I really do not know why I am tired in the morning and feel sick only 7 hrs after dosing…. my nurse says I should up my dosage so I’m not feeling this way… but if I’m nodding out after medicating… itll only get worse as I increase my dose… PLEASE give me some advice as to what this may indicate… thanks

They won’t split the dosage up if you are at s clinic.you have to take the full dose early in the morning. I have been fighting cancer, but the cancer centers won’t give opioids for pain anymore. I had zero quality of life being in so much pain and agony. They had cut me off high dosage of Fentanyl patches and Dilaudis cold turkey. I said piss on it and went to the Methadone clinic. I do have a much better quality of life now, but would do much better if my 140 mg we’re to be 70 mg twice a day. None of the clinics will do this. I do it on Sunday with my take home dose and feel so much better. I’ve never had a dirty UA or had any violations yet take home doses are only given on Sundays and holidays. I think Michigan law prohibits this because of the risk of diversion. There’s so much stigma tied to it all. The police sit right outside the clinic and arrest people for even lighting a cigarette in the parking lot. It’s sad when cancer patients and people who are as unwell as I am cannot have medications that give some semblance of life quality.

It also takes time to get used to. I used to fall asleep and be very drowsy a few hours after i took my medication. It’s a rough side effect. However feeling sick is something that’s happening way too soon..imo..but there are several things that interact with methadone and eat up the dose….caffeine, alcohol, other medications…just a thought. Good luck! Oh and they can do a test to see how quickly your body is metabolizing your dose so maybe you should ask about that because you could need a split dose…i did.

DON’T let the clinic talk you into upping your dose without asking them to test you to see if you metabolize MD more quickly than the average bear. That’s really quite a high dose so no reason for you to be having w/d symptoms by noon. Split dosing is a pretty good option if you are a “fast metabolizer”. I’m sure the clinic would love to just arbitrarily raise your dose but remember what goes up, must come down (assuming you dont want to be on the stuff forever)and coming down is a lengthy and uncomfortable process.

Really I am on 170mg and I would be ok for the next couple of days. 120mg, 130, it’s all pretty much high doses of methadone, not quite sure why you’re Feeling withdrawal symptoms so soon after seven hours of 120mg dose?? I guess you have a high tolerance.

When I first started my doctor told me basically I would still use until I was at a stable dose and my body was use to the methadone . Basically transitioning. Eventually you’ll be use to the methadone and won’t be one bit tired and be on a strong enough dose that it will last all day and any opioid would be useless not having any effect as the methadone blocks out the urge and the euphoria

Talk to your Dr. About doing a split dose. Not all clinics do this(my clinic is only one of 2 in my state that does) but it is definately worth asking. If the clinic offers this option they will likely require to do a peak/trough(“troff”) blood test to check your metabolism rate (and since the federal government requires them to provide justification for sending more medicine home with you). I was in the same situation though, kept raising my dose, would sleep a bit in the am, started to feel ill shortly after my nap. My anxiety actually started getting WORSE with each dose increase because I felt like I would never get propped relief (not to mention I had to wait 2 weeks between increases at doses over 130). It wasn’t until I started splitting my doses that I actually found the relief I was looking for, and it wasn’t immediate either.
When I first started splitting my doses I was at 160mg so I did an 80/80 split. Even at 80/80 I felt off an had withdrawl like symptoms and felt like I maybe needed an 80/80/80 (three times a day split with a higher daily total), it was still discouraging.
I eventually started tapering out of frustration with the intention of switching an alternate medication, but what ended up happening is i actually started feeling better and stable at a lower dose. What was happening is that at the higher doses I was experiencing relief in the morning shortly after dosing, but at night side effects would kick in and they were VERY similar to withdrawl symptoms. I would get hot flashes followed by cold chills, extreme anxiety, and sleep disturbances. I am now currently taking 40 every 12hours(80 a day), instead of the previous 160 every 24 and feel great.
I also want to note that before this experience that led me my current dose I was at a different clinic and stable on 110mg every 24 hours for 12+years without issue. It was only when I switched clinics that my dose needed adjustment. What happened was the 2 clinics used different brand of medications(one used brand name mallinkrodt methadose, and the other vistapharm methadone, both cherry liquid), and while they were both “methadone,” the way my body processed them was very different. One brand provided much higher analgesic relief and lasted longer, while the other had effects that were so subtle it was difficult to tell when you took actually to much. The difference was actually so notacable, and so many transfer patients complained of the methadone being “weaker,” that my doctor eventually started having random dose samples pulled and tested to make sure they hadn’t been tampered with and met established manufacture standard levels. Ultimately, no tampering has yet to be discovered(or admitted to) at this clinic. That is really another issue all together though, one i have seen a handful employees lose their job from over the years at my first clinic.
My overall point in mentioning this is just that methadone is complicated, effects can vary from body to body and brand to brand(due to additives and differing balance of D and L isomers). All you can really do when taking methadone is work with your Dr. and find a treatment plan that works best for you.
Best of luck and I hope all works out for you…. First thing first, though, ask about split dosing. Split dosing will not only possibly solve your high peak/early fall off issue, but you may find you just feel “better”. Methadone only has a window of 4-8 hours of analgesic relief so more frequent “lower” dosing may result in less pain issues through the entire day, instead of just a few hours in the morning.

I am a 260lb 63 year-old white male diabetic (BG averages 150). I have been on and off of narcotics since 1979 when a car wreck messed me up. My primary injury at that time was removal in the wreck of my entire left femur, a left TBI and was in a coma for 42 days. I spent the next 2 years in the hospital and the next 20 years in and out of hospital trying various forms of rods, allografts and cadaver grafts after a nasty osteomyelitis from a 1982 surgery led to eventual above-knee amputation in 1999.
A neuroma developed at the distal L5 nerve amputation site which left me in chronic pain and unable to wear a prosthesis to this day. For several years I got around well on crutches.
Then in 2003 I fell down a stairwell and dislocated my spine at C6-7. Surgeons refused to do the necessary surgery due to the ongoing osteomyelitis for several years.
Finally in 2005 they did the cervical spine fixation surgery and my heart quit in the middle of the operation. They had to stop the surgery incomplete and get me pumped back up, then do a CABG (quad bypass).
They never completed the cervical fixation procedure so now I have a second source of chronic pain radiating from my c-spine.
I was, over the years, on a variety of opioid pills graduating as I became opioid tolerant to fentanyl in the forms of extended-release Duragesic patches and immediate-release Actiq suckers. These covered most of my pain but made me a zombie, sleeping all the time. 18 months of that and I was useless, so I had to decide to either get sober and healthy or kill myself. Dying didn’t seem like a good option so I threw all my fentanyl patches and suckers away and came off all pain-killers cold turkey without even telling my pain management doc. Yes, that was dangerous and stupid but it beat the only other alternative I saw, which was a one-way fishing trip. Let’s just say that the next four months were no fun, but at the end of that time I was drug free and had my brain function and life back. I hurt like hell, but it seems the trade-off is being in pain or giving up mental functions that I kind of enjoy!
I was drug-free for three years, then fell while deer hunting by myself deep in the woods where no one knew where I was when a crutch dropped into a deep hole where a stump had rotted out and the crutch bent in half, unusable. I was about a mile and a couple hundred yards downhill from my car so I had to slide along the ground backwards pushing with my good right leg. No fun at all.
I went to a different pain management specialist who put me on a gradually escalating dose over 10 years until I was taking 120md/day ER and 40mg/day IR Morphine Sulfate. That medicine held me at the perfect balance of mental function yet adequate pain management for years. I think I was on that dose for four years.
Then I moved from AL to PA in 2016. My new Primary care doc continued me on that dosage but sent me to a pain medicine specialist for all pain-related treatment. He kept me at that same dose from 2016 until four months ago. Then he claimed that new PA law now prevents him from prescribing more than 100mg/day total Morphine Sulfate. He offered to cut my dose to that level or change me to Hydromorphone 8mg every 6 hours. He said the 8mg/4*day hydromorphone was the equivalent of the 120 mg/day Morphine I had been on so successfully for years. It was not. I tried it for four months and it’s back to the roller-coaster effect I had 20 years ago with pills like hydrocodone, where I got decent coverage an hour after taking it then a decent effect for 3 hours then a sharp taper down till the 6th hour when I could take one again. It’s literally comparable to life on a roller coaster if graphed.
So today he tells me that “changes to PA prescribing law” are making him cut back on hydromorphone total daily dosages, the same thing he had said previously about morphine…I can cut back to 8mg/3x day instead of 4x day, or he can change me to Methadone 5mg q 8 hours and in 5 days move up to 10mg q 8 hours. Basically what I interpret from the man is that he’s willing to change to most anything but he’s being limited on how high the dosages he prescribes can be. I don’t know if that is truly new law or if he got in trouble with the state and is being closely monitored or what is going on.
So, tomorrow I stop the Hydromorphone 8mg every 6 hours and start 5mg Methadone tablets every 8 hours, then in 5 days move to 10mg every 8 to 12 hours as needed.
Do you see any problems here? Will I again suffer withdrawals because of the abrupt change? I need another doctor to tell me if this is a sane and effective course of treatment but we only have 2 pain management specialists in PA and the other is 5 hours away. Any ideas will be appreciated.

This is true, but with the ”opiod crisis”going on- which in my opinion is total BS, the only crisis I see is the one being initiated by our own government that is coming down hard on PATIENTS mind you, not prescribers, but patients who are now considered addicts, turned away from ERs with the coined term of ”drug seeker”. Excuse me, someone needs to put responsibility where it is warranted..the physicians. Drug companies like Pfizer are getting nailed with law suits, and why? Because they lied? No, they told the facts, maybe with less emphasis on negative side effects but come on, who are they providing the information to? Physicians who know exactly what opioids do, they know what side effects to watch for and the risk of addiction. They went to school for how long? Were educated on what? Drug reps aren’t responsible for the 25yr old that broke into the local pharmacy to obtain the drugs he needed for his addiction, instead the blame belongs to the VERY educated doctor who continued to prescribe said patient an ever increasing amount of oxycodone and then- out of nowhere, tell said patient- sorry dude, you’re a drug addict and you need help if you can’t stop taking the medication that I told you to take for 5 years. You cooperated and were a compliant patient, so now I’m punishing you for it. And. I really can’t explain why you can’t have it any longer. It has less negative side effects than Tylenol or Ibuprofen. The combination medications are somewhat comparable to the side effects of over the counter pain relievers..and that’s because they contain OTC medication that has a synergistic effect when combined with a synthetic opiate such as hydrocodone (the synthetic opiate ingredient in Vicodin). Oxycodone taken alone has great results for pain relief and when used appropriately, is much safer than OTC versions of pain relief. Maybe it’s that horrible side effect listed that makes the law come down on it..”Euphoria” is a side effect that must be squashed and removed immediately from the shelves. What havoc may be brought upon us for the risk of feeling euphoric…oh my.. Seriously! Yes, it has potential for abuse – hell ya I wanna feel good too..but most people understand moderation and abide to the instructions as listed. Just like we do with alcohol or chocolate. Moderation is key and we all over indulge occasionally. So what!? It happens. Don’t take ten oxycodone and decide to fly down the freeway (for some reason, every delusional person who has no idea of the real side effects of drugs truly are, believes they must make those indulgers think they can fly.. Think about it..every educational film about drugs before 1999 shows the ”high” individual attempting to fly… Why is that? I’ve always wondered. Anyway, my point is- why are opioids being treated as a detrimental, life ruining, people running amuck confused, evil, and soon to commit a theft of something horrific? Or is the real reason possibly the government wanting to profit from this market, they are the biggest drug dealers after all, and reducing supply means the demand will escalate, making crime inevitable and the beds remain full at the now privatized prisons whom profit off the inmates. We have more non-violent crime incarcerated (victims) people than any other country in the world I believe I heard recently, if not the highest, very close to the highest, I don’t want to state something that I’m unsure of so don’t quote me but look at our nation, land of the free? What a joke. And I would sincerely like to know who can tell me why opioids are being blacklisted. We need to use our heads and recognize that something is very wrong with this supposive ”opiod crisis”. IT DOES NOT EXIST. And those pointing fingers need to reset the alignment and focus on putting a stop to this. The big pharmaceutical companies applied this exact scenario to the costs you pay for said opiate prescription. They weigh it out..hmm, if we get sued by 30% of prescribers and lose 75% of cases initiated against us- we still profit by 2 billion. Carry on, just a minor setback.. Who gains in this situation? Well I know the county I reside in is suing big pharma..winner winner chicken dinner. Our government deserves a pat on the back. They somehow always come out on top.. Is euphoria so terrible for the hard working residents of our country? Maybe they deserve a pat on the back for once?

Okay you are so wrong. I am a medical professional. There is an opioid crisis. Allow me to explain what has happened. In medicine we have something called OSHA and JACHO, also known as the joint commission. About five years ago they decided to include pain as the 5th vital sign. Ask any nurse or doctor how they feel about JACHO…anyhoo, due to “patient reviews” and complaints, it was felt that pain was not being managed well enough by doctors/medical professionals, so JACHO made the rule that pain now had to be the 5th vital sign, along with blood pressure, pulse, etc.. So, if you are having patients have major surgery in a hospital and they are receiving heavy duty doses of dilaudid, morphine, and fentanyl, what happens when they go home? You guessed it. They were going home with 3-3 weeks worth of Narcotics of just about any choice. When the Narcotics ran out they would call for refills and that is where there is a slippery slope. Most surgeons would turn them away, leaving them to ask their primary care docs. If the primary care docs said no, then patients had two options: find a pain specialist or buy the meds on the street. Pills on the street cost a cool $40/pill (according to patients) and most are taking 10-20/ day. That is extremely expensive for the average individual. That is when most turned to heroin. It is cheap, available, eases, and the pain. It also ruins your life. This is when we started seeing people on the side of the road slumped over high with car seats in the back of their minivans…this is a crisis. You are misinformed.

Yes, but the majority of overdose deaths are from Heroin/Fentanyl, not pain pills. I’m a cancer patient. I’ve had a lot of radiation, chemotherapy and surgery. To say I have chronic pain is an understatement. My oncologist and his associates are discouraged from writing any type of opioid script. Primary Physicians won’t write them at all and send all their patients with chronic pain to pain clinics. The pain clinics do not manage pain, they taper everyone on opioids, off opioids. So that leaves the Chronic pain and cancer patients with 3 options: suicide, which is happening at a record clip, buying illicit opioids from the street, or getting into an addiction clinic that offers MAT or Medication Assisted Treatment. I know many, many chronic and cancer pain patients, myself included who now go to these places. I take Methadone, a moderate-high dose. I get this liquid every morning and I have my quality of life back. I tried the safer of the two drugs you had to choose from: Suboxone. It stopped the terrible withdrawal symptoms that I had from being cut off my pain medications from the cold Drs who didn’t care even a little bit with how terrible I would feel. But the Suboxone did not help with the cancer pain that still remained. So I asked the Dr there to switch me to methadone. It helps with pain more than suboxone. I can function and have some quality of life. It’s sad that I, a person who does not consume alcohol or co some, heroin or any type of street drug must go to an addiction clinic. Where the police squat in the parking lot every morning and hassle the patients, arresting them for silly things like smoking cigarettes. Apparently it’s illegal to smoke in the lot. I’m treated like a lowlife and why? Because I had cancer and had the audacity to not want to live in horrible debilitating pain every hour of everyday. What our government has done to people with intractable pain is despicable. There’s just no other word for it. The government is doing this to fill prisons and remove the dregs of society. . Most chronic pain patients are elderly or living on Socisl Security disability. By targeting them, they drastically increase the chances that these people will commit suicide, overdose or end up in prison. Any one of these things occurring would remove said person from the social security dole. The society as a whole would become younger and healthier and politicians could take credit. This is not Nazi Germany of the 1930’s this is the USA in 2019 and it’s really happening. Shame on our physicians for going along with and facilitating this farce!

Methadone is a wonderful, long-term drug for addiction & pain. I think you will like it because you won’t feel like you’re on a roller coaster ride anymore. It lasts a long time in your system, so there are not these ups & downs like with other pills. Good luck!!!!

I wish someone had warned me off methadone before I got started. Do some research before getting eaten up by this awful drug. While the withdrawal for opiates such as OxyCodone and similar is about 7-10 days before the worst has passed, methadone withdrawal is MONTHS long. It’s due to its long half life – it will get into every fiber of your being and withdrawing is sheer misery. Been there, done it, and even with the help of Buprenorphine, I just wanted to die. Not sure about the laws in PA but pharmacies nationwide (Walmart and you can get other big box pharms will follow suit) are drastically reducing the amount of morphine equivalent doses of methadone they will dispense, which will only leave you with the option of going to a methadone clinic to obtain a higher dose and that’s just another expensive, time consuming nightmare. Our local clinic is up to $18 per day and no insurance accepted for it. Really, do your research before making this move.

On methadone for chronic pain for over 10years. Tapered to 40mg total daily & 10mg oxycodone for breakthrough pain. Dr said i had to STOP methadone, latest ekg showed prolonged qt. Ive never had a bad ekg before. Switched me to oxycodone 30mg 4x daily. Am scared of withdrawal & afraid pain will get worse. Is this dose a good equivalent?

This conversion should be done VERY slowly, as one is tapered and the other is slowly added. Doing it as a straight conversion is very dangerous because not all patients handle these drugs the same way.

that’s because these are addicts and they relapse… It happens so what happens if they didn’t dose them or kick them out of the clinic? they will just go by there illicit drug of choice and then they’ll have a total relapse and never come back to the clinic so what good does that do?

Like Dr.Jeffrey Fudin said, “It is not a law”! There are new guidelines, but they are not new laws.I do not agree with the your negative comments on methadone! If you take it as prescribed you will not experience any withdrawal! I have been on it for years and my experience has been vert positive and it has helped me more than anything else out there! Also, in some places, like where I live, there are clinics that take insurance, and if you do not have ins. you can qualify for free treatment! Good luck!your exactly right!

Very ignorant and misinformed comment. Not trying to be mean. Yet you must study addiction and treatment more closely. It sounds like you know nothing at all about addiction other than biased perspective which may help you but not others. Don’t be so hard on something you have very little to no understanding of.

Methadone for Spinal Arthritis for 15 years ,started at 80mg / day. Since new guidelines I have been cut ( slowly) to 60 mg / day..Is this a large dose? Seems as if my pain has increased. What is the Mme for 60 mg / day.? Thank you.

I have a question hoping for an intellectual reply.If there is a patient that has been taking 85 mg’s of methadone for a 9 year period and has been successfully stable then asked to switch to the brand name liquid form of methadone but can not metabolize it well at all .What would be your factual conversion do to this patients metabolic profile.
A.Do you think it’s wise to interrupt patients long stretch of stability or,
B.Should thy patient be left taking what is best suited for his metabolism so instability is interrupted

Methadone is available in different mg tablets, but it has been my experience with others I know ,that a Dr will not provide the same amount in tablet form as they do in liquid, since that is a large dose they would probably work with you to find the amount that would keep you comfortable, as tablets are given 2 to 6 times a day instead of all at once.

Hi Dr. Fudin, thank you for what you’re doing here. You’re helping so many people! Even those in Europe who just read your website for support/information 😀

I have a problem with chronic opiate addiction and heroin use, but I have never abused methadone. Currently I am using approximately 125mg brown heroin, in doses of 10-20mg evenly spaced throughout the day as needed (I have a proper milligram scale, I weigh out my doses exactly). I have done so for almost two weeks now. A few months ago I read on a forum that you can quit heroin without any withdrawal symptoms if you use methadone to taper. This is the blog post I found: https://opiated.wordpress.com/2007/03/26/how-to-kick-a-habit-easily-with-zero-discomfort/

The thing is, last year around October (2018) I had been using 100mg of heroin daily for exactly 19 days when I started the methadone taper. 12 hours after my last heroin dose, when I started feeling withdrawal symptoms, I started taking 10mg of methadone every 2-4 hours until I couldn’t feel the withdrawal anymore. It quickly became apparent that I needed about 30mg of methadone per 24 hours to prevent almost all withdrawal symptoms. I write down all drugs/medications I take and this is the taper schedule I ended up using:

As you can see, at first I tapered too quickly. But now the thing is; it worked. Other than some mild sweating that would come on suddenly out of nowhere I experienced no withdrawal symptoms whatsoever. Even the weeks after, nothing. I have searched online as to how this works but I am having trouble finding any real information on this. Do you have any insight as to why the methadone might have alleviated my withdrawal symptoms and more importantly, why the withdrawal did not come back after stopping the methadone? I have detailed logs of my heroin usage in the preceding weeks that I can send to you if needed.

Ron, Methadone works because it uptakes and occupies opioid receptors which in turn normalizes the central nervous system balance of noradrenalin. When chronic opioids are abruptly stopped, or tapered too rapidly, the neurophysiology of the brain does not have time to readjust. A simple explanation is the following…
1. Acute opioids cause drowsiness because the diminish noradrenaline (NA) release in the CNS (NA generally causes hyperexcitability or wakefulness)
2. With chronic opioid use, your brain adjusts to make more NA so that continued exposure to opioids doesn’t leave you tired.
3. Abruptly stopping opioids now leaves nigher amounts of NA because the brain doesn’t have time to adjust NA production downward. Now you are hyperexcitable and have massive amounts of NA – that preents as withdrawal, THEREFORE, and other way to treat withdrawal is with
4. Clonidine, which is a centrally acting alpha agonist, which in lay terms is and antihypertensive drug that blocks NA receptors.

Now I’ve got a question for you! Without providing any specific, how in the world does one obtain morphine, heroin, and methadone if you are not under the care of a physician? And for the record, YOU SHOULD BE TREATED BY A PROFESSIONAL. DOING THIS YOURSELF CAN BE PHYSICALLY AND MENTALLY DANGEROUS, including harm or death.

I’m actively working on being opioid free. I have been on some form for years 18 years. The latest dose was 120mg/methadone every morning. I’ve tapered down to 15mg/day and have an appointment for a buprenorphine intake in 6 days. I was hoping to use this method of switching and that using a partial opoid would be easier to fully taper from a lower dose.
I took my last dose of 15mg on 3/19 and have 18 20mg oxycodone (light green, round, epic pharma stamp E 7) and 9 15mg IR morphine to get me through the week. My questions are…
1) Would it be possible to completely taper off opioids comfortably with what I have and forgo the buprenorphine entirely?
2) What’s the longest the last dose of methadone would be in my system? As in should it be out by tues?
3) Should my PCP be afraid of prescribing a short acting benzodiazepine for the duration of the transition for sleep?
I can’t seem to find any literature on these specific issues- aside from drug prevention propaganda.

Benzo are very dangerous during this transition. To blunt withdrawals your doctor can prescribe clonidine or Lucemyra. Methadone can stay in the blood 7 days to over a month – it is highly variable depending on genetics.

Jilly I have been in your situation many times unfortunately.
If I was you I would continue to taper off methadone reducing 1mg every 5 days or so. If this is not leaving you feeling withdrawals maybe 1mg every 3 days. Just make sure you don’t start suffering by rushing things.
When you get to 5mg you could try 1mg a day then that should be that.
Just to clarify in the UK methadone is in liquid form dosed 1mg per 1ml of solution making tiny dose adjustment easy.
Basically at such a low dose, switching with tablets to then switch to another product is a lot of messin arou at such a great point that you now are.
When I have done this way with small adjustments I’ve been able to come off with zero issues or withdrawals whatsoever.
Wishing you all the best, I know it’s a bit old now so much love from the UK.
Rob.

thankyou. do you know how long methadone keeps blocking opiates after last dose?i ve been on methadone for years for chronic pain. now my docyor switched me to morphine I feel like hell. will it take weeks for the morphine to start working and the methadone not blocking?

Good point, also, unless he is in Europe, how in world does he know how milligrams of Heroin he is administering? My question to you is regarding the increase in the brain with concurrent opioid use. Does this also suggest that the concurrent use of sympathome.tics while treating long term pain with pure agonists, will reduce sympathetic outflow when opiates are withdrawn: by reason of feedback inhibition of reuptake of NE?

hi im taking 100 mg daily of liquid methadone. whilst still in pain, i was also prescribed 5mg bupenorphine patch that stays on for a seven day time frame. do i need to worry about a fatal interaction? im a bit sedated but finally no back pain. thanks

The DEA shut down my pain management doctor two weeks ago. I went into severe withdrawals. So a friend told me about a methadone clinic. I have been going to the methadone clinic for one week. My family doctor I saw yesterday is going to get me into a new pain management doctor. Will the methadone show up in my urine test as methadone? Or will it show up as oxycodone? I am afraid to tell my new pain management doctor that I had no choice but to go to the methadone clinic. Thank you for reading my question. I feel like a leper because I am in chronic pain I’ve already had seven surgeries and need at least two more before I’m done and then I want to get off at this pain medicine as soon as possible because I’ve already been on it for 10 years and I’m scared the government is going to make all pain medicine totally illegal in the future anyway.

Stacey, Methadone will show up as methadone (if tested). You need to be honest with this new doctor up front, otherwise you’ll be right back in the same boat when he/she finds out, and perhaps even worse off because you were dishonest and it will be reflected in your chart and follow you around.

Ok this has nothing to do with methadone But i didn’t know how to ask a question so here goes my son is 29 years old he suffers from a rare kidney disease called Loin Pain Hematuria Syndrome ( its like passing a kidney stone 24/7 ) his pain management doctor put him on Percocet 10/325 and 150 belbuca twice a day Will the belbuca make the Percocet not work properly

How can one use bupe and Percocet at the same time?bupe has a higher binding affinity and would instantly remove all full antagonist s from receptors causeing instant withdrawal… also while clonidine is better than nothing its effects to dull withdrawal from any long term iv opiate addict is like a band aid on a compound fractor

Im a 37y/o male from Scotland, and after losing my left kidney, i have LPHS in my right, daily bleeding, and absolutely hellish pain, its horrific.

By contrast, and bear in mind Scotland is different, i use 40mg Oxy 2x per day, and up to 6 10mg short acting oxycontin-it seems to work ok, but when it gets really acute, theres little that can be done, its just that painful. One thing i did try with mine, is something called Diclofenac. It isnt an opiate, but added to the opiates it seems super effective vs our type of pain-i think it belongs to the NSAID family-knowing his pain, its worth adding in to the mix.

No, morphine and oxycodone do not stay around for more than 3-5 days after last dose and there is less variability from patient to patient compared to methadone. But, buprenorphine will predominantly occupy the receptors and precipitate withdrawal similarly with all three, methadone, oxycodone, and morphine.

Thank you so much for all the great information. I’m truly amazed at the new drugs like lofexidine. I brought it up to my Dr but knowing the reluctance to prescribe new drugs in the addiction medicine field (like vivitrol and buprenorphine) and just how long they take to “catch on”…I’m not hopeful, but for the generations to come- it is very optimistic. Although this is the trend that seems to cause overdose, lower quality of life, and perpetuates chronic pain.
It will be lovely if we can live in a future that all physicians actively take interest in treating addiction and upholding the oath to (truly) first do no harm. Separate the stigma of addiction, curtailing government involvement in practice, and supporting patients with chronic pain.

Dr. Fudin, I took your advice and I went in after 5 days without anything for withdrawals. My cramps in my stomach were bad . I took your post on Clonadine and that’s what they gave me. The only problem was, it caused terrible dry mouth. So they gave Dicyclomine HCL 10 mg. It’s for severe stomach cramps It made a big, big,difference. I wish I had found your web sight ,7 months ago Thanks, Dr. Fudin.

Dr. Fudin, I have been on methadone for pain for to long. I new after 6 years I need to get off and suffer with the pain. I just couldn’t past the ideal of getting off. It took 4 more years and a grandchild. My Dr. started me on a dose of 70 mg.. I asked to taper down to 30 mg. I went back to 60 mg until I heard the good news. I went to 30 mg my next visit. Surprisingly, it worked as well as the 60 mg. After that I went to another Dr. and asked for help get off it. This Dr. dropped me 20 mg and 10 days later a drop to 17.5 mg and 21/2 deduction each month until now I’m off. I have been off 3 1/2 days and the with no methadone. I have to admit it is uncomfortable and I have lost 30 lbs. How long can I expect this to go on. My Dr. said come back in a month and keeps pushing medical marijuana but I told him it doesn’t help and stopped taking it. I found the cbd oil helped more the med marij’ I told him to cancel my licence for medical marij. For those who want it, better have money. My Dr.wanted almost $1000 over 1 year and $40 a month cash. That’s the cheap part. Wait until you go to purchase it. I quit after 5 months. “Now Dr. Fudin, the question for you.” How long can I expect to be going through this?” Its been 5 months of uncomfortable time, but I’m off 31/2 days and I lived through it. Please get back as soon as possible if you can, Thank you

It’s hard to predict how long you’ll have withdrawal. But, your doctor should be kind enough to give you what really works to prevent withdrawl – clonidine or Lucymera. The latter is relatively new and only FDA approved for acute withdrawal. Clonidine has been used as a standard of care off label to treat or prevent withdrawal. This is a discussion you should have with your doctor. Marijuana does not prevent withdrawal, although it may make you care a bit less about the symptoms.

Dr. Fudin, I was on Methadone for 9 years for pain relief. 23 years ago I was 4’8″ 300lbs. I was one of the trial Roux en-Y Gastric bypass patients on 11/19/96. I went from that size to 79lbs 4’11”. I was 25, obviously I didn’t have a growth spurt. Eventually I evened out at 95lbs and have stayed around that for the last 21 years. I got pregnant with my first son at 32. No problem until delivery, they left him stuck in the birth canal for almost 40 hours with NO MEDS! anyway, after I had him, my back pain was so bad I couldn’t walk. They put me on liquid Morphine. DIDN’T like that AT ALL!!! Switched to Norco 5/3.25. OK. Then SUPRISE I get pregnant with my youngest son and OB/GYN says “Can’t be on Norco while you’re pregnant.” “You need to go on Methadone. Never having done illegal drugs was not familiar AND trust my doc. Anyway after 9 years I was up to 190Mg. Jan 1,2019 I started self detoxing. I cut down from 190 to 45 for about 2 weeks, then cut down to @ 10m for about a week then quit. I would take 1-5mg every 5 or so days when withdrawls got bad. Now it’s 2/15/19 and some days symptoms are so bad can’t get out of bed. Need to be able to work 7 days a week/12 hours a day. I am now getting ready to start CBD:THC 1:! ratio for withdrawls. Good idea??? PLEASE RESPOND ASAP as planning to start in 2-3 days. THANK YOU!!!!!

I have been in methadone for 8 months now, I am 41 and have tapered down from 50ml methadone once daily down to 21ml. I tapered down 2ml every week until I got down to 25ml and am tapering 1ml every day atm. I would like to know a safe and fairly pain free way to taper when I get down past 20ml. Is 1ml daily too much? I’m a recovering addict and am determined to live free and clean. It’s just I need to be able to function in my job.

Also I am due to have some dental work carried out under sedation using midazolam. Does methadone effect midazolam ?

I cannot answer your question for a number of reasons, not the least of which is not having access to your medical record. Also, milligrams, not milliliters is the important measure for dosing. Yes, midazolam is very dangerous with methadone or any opioid, but if its in a controlled environment with a doctor that knows you’re on methadone it should be okay because midazolam has a very short half-life. But, I’d stay around the dental office for a couple of hours after the midazolam at least.

Question please i was taking 160mg daily of oxy time release i just got switched to methadone . How many mg would i need to equal close to 160mg oxy i know its all different but any ballpark figure can help me please thank u

I was taking 90 mg of methadone for 8 years for complex regional pain syndrome. With all of the opioid witch hunts, my doctor has me down to 60 mg of methadone per day and my pain level goes up markedly each time he drops my dosage. He tells me he has no choice but to do this. Could he add low dosage of tramadol to help with the breakthrough pain?

Tramadol would be totally inappropriate for several reasons. He could add tapentadol on an as needed basis. If, as the methadone continues to decrease, the pain increases, he could add memantine (used for alzheimer’s usually). Let me explain. Both memantine and methadone have a unique property to block NMDA receptors – these are responsible for neuropathic pain. Print this out and bring it to him with this, Zorn KE, Fudin J. Treatment of Neuropathic Pain: the Role of Unique Opioid Agents. Practical Pain Management. 2011 May; 11 (4): 26-33.

I’m on the med reduction train too, from 10mg 3x/day to 10mg/2x a day. I can see now, comparatively, it’s a rather low dose. My pain & fibromyalgia flaring has skyrocketed between the 12 hour gap. I think the CDC needs to stay out of my business with my doctor!!
Good Luck all!!

Your wrong methadone does block other opioids .u can not feel them right ..I know I been on .methadone and oxycodone for 20 years i just was switched over from 40mgs of methadone to 20 mgs of oxycotin 2 a day ..which withdrawal is a bitch .but the whole time I was taking the methadone on 85 mgs a day I could not feel the 30mg of oxycodone ever if I took 4 at a time

Jamie, There are other reasons for your experience, but blockade of opiate receptors is not one of them. If you have interest in this and are good at science, I suggest you go to a medical library and read Goodman and Gilman’s Pharmacological Basis to Therapeutics.

Hello, I have been taking 2 10 mg oxycontin ER and 4 10 mg oxycodone instant release for over 10 yrs now. With the new changes to the rules my DR has prescribed me 2 5 mg methadone oral pills per day with 3 10 mg oxycodone per day for break through. I don’t like the stigma of methadone and now I am nervous about the interaction of the two meds. What are your thoughts.

Jeffery,
Is their a problem with dosing if you take 30 mg at 10mg tid or 5mg every 4-5 hours. The 4-5 hours works best for me and has for years.

I have been taking methadone for about 20 years for chronic pain being seen by pain management specialists. Prior to that I took OxyContin but had no problems changing over to methadone. The benefit to methadone is it can be cut in half when needed but oxy can’t.
Because of the government shutdown on opioids doc had me change from 60 mg tid a month to 30 mg a month for 2 months. I was suppose to do 10 mg tid but because of pain took 5 mg every 4 to 5 hours. I can manage that. Now I’m down to 20 mg bid I’m doing 5mg qid. After 4-5 hours my hands and feet burn more. I have feet burning syndrome so I take Gabapentin for that but the methadone withdrawal makes them burn more.

I have been on methadone 40 mg daily for 15 years, for severe chronic pain. Now because of new regulations, and my doctor retiring, nobody will prescribe it. I found a doc to switch me to oxycodone er 40 mg daily -taken 20mg bid (after a very awful wean from methadone.) I was doing well before all this. I am a good mom, wife, and person. I had as normal of life as a person in chronic pain can have before this. Now my pain is totally out of control. Then on Tuesday, doc prescribed tramadol for breakthrough pain. It is like speed to me. It dilated my pupils, made me jittery, anxious, and unable to sleep or eat. And that was just 1/2 a pill (25mg.) I have always been very sensitive to drugs, and have had adverse reactions before. Cymbalta was prescribed for pain, and I got the “suicidal thoughts” reaction. Same w/ lyrics… I feel like a guinea pig… I think we just need to adjust dose of oxycontin er, but I’m waiting to see doc next week. In the meantime, I can’t walk -too much pain. I’m in Michigan’s upper peninsula, and it was -25 this morning. Among other issues, my femur is bone covered in metal, encased in more bone. Even UofM declined my case- twice. Nothing can be done. Just manage the pain… But it’s not managed. Not like before. I feel like a shell of myself, and my kids and husband want me back! I’m constantly in pain! Trying to stay hopeful.

Angie, Methadone is very different than oxycodone in many ways. For example, in addition to the opioid activity, it blocks NMDA receptors. If you can’t tolerate tramadol, it doesn’t surprise me that you had problems with duloxetine, because both inhibit reuptake of norepinephrine and serotonin. It also make absolutely no sense to be on tramadol when you’re on that dose of oxycodone. Tramadol has thousands times less the binding to the same receptor where oxycodone works. A comparison would be a single drop of water placed into an olympic size swimming pool. See Zorn KE, Fudin J. Treatment of Neuropathic Pain: the Role of Unique Opioid Agents. Practical Pain Management. 2011 May; 11 (4): 26-33.

I have been on 4 Hydrocodone 10/325 per day or years for chronic pain.
My new doctor has suggested to switching me to Methadone what is your thoughts on this. I always thought methadone was for heroin addicts. Will it kill the pain? How much Methadone do you take to convert your body from 4..10/325 Hydrocodone?

James, Methadone is often an excellent choice for the right patient and can work as well or often better than hydrocodone. It is not for addicts ony – it s used for them because it sticks around in the body for a long time and can therefore be doses once per day while being observed in a methadone maintenance clinic. For treating pain it is generally does 3-4 times daily. it should only be prescribed by someone very experienced prescribing methadone.

Short version of a very rough life. 3 serious MVAs. 1 in 1983 at 21 years old. 60 reconstruction surgeries til I got tired of them and never finished my face. 5 years rehab. Went back to college. Had career. Managed pain. Was rehabilitation service Director. Had PT do ultrasound on my back. . 1 in 2007 at 45 years. 7 surgeries. Never healed. Perment disability. Unyielding pain. Prescribed hydrocodone then oxicodone er and ir. 4 80s and 10 30s. 1 in 2011. 6 shoulder surgeries. Have thr, reverse total shoulder replacement, and rods pins and wires around spine. Permanent nerve damage.
Dr. Got fired. They sent me 70 miles to ” pain Dr. ” LOL. Took me off everything. Bad w/d
Even took away sleeping pill and Xanax. Oh and Baclofen used for swelling inside my vertebrae in my neck. Put me on suboxen. Had severe allergic reaction but I was so psychotic I didn’t realize it. The 3rd day on it to the 6th I was in a bad place. Ended up in er. Now he’s going to put me on .5 my of methadone 2xs a day. Isn’t that crazy. He must know it won’t work. Why drive 140 miles for .5 my. They even took away albuterol tablets. So my cold is acting up. 11 years on opioids, sleeping pills, antianxiety medication and I had no problems with respiratory depression. Now he won’t give me .5 methadone with zanex because this might happen. If it never happened on my old medicines. Why would it happen now.
I am pissed. The government should not run health care. Fentanyl, heroin, street drug over doses should not be put in with pain medicine. It inflates the “crisis”. And people who need pain medicines should have them. They don’t even have a good assessment tool to decide who needs medicine and who’s gaming the system.
I went from living with minimum assistance and ambulatingi to being dependant on w / c . i have no quality of life now. I feel like a lab rat.

Dr fudin. The pain Dr who is in fact a internal medicine dr and new to pain mgmt to away my oxicodone. Prescribed me with Suboxone which ended me in er. He then prescribed me methadone. It is not helping my pain in the least. Am I being for irreparable chronic pain or an addiction I never had? My anxiety is threw the roof. How long does it take methadone to work? Is this a stain on my medical record? Does it look like I’m being treated for addiction? Will any physician ever treat my pain after this?

Pamela, Methadone should oly be prescribed by a VERY experienced clinician. Methadone titration takes several days to weeks if done properly. The dose cannot be adjusted quickly because it accumulates (sort of sneaks up on you) and can cause death if not done carefully. If you have an experienced person prescribing it, he/she should know how to do it. It theoretically should not be a “stain” on your record, but some people see methadone and jump to conclusions. generally for opioid use disorder it is doses once daily; for pain, it’s generally in divided doses of 3-4 time per day. I cannot predict what other physicians will or will not do.

I have a very complex history of chronic pain combined with addiction. Going back to the year 2000 I was prescribed OxyContin before having surgery to correct some back issues. I have since had four other back surgeries, and have been on methadone maintenance treatment at a clinic since 2005 after difficulties weaning off the oxycodone products. The issue I have is that with over 10 years of compliant drug screens and clinic programs, because of the guidelines the clinic must follow, I still have to take my 100mg dose once a day instead of divided multiple times per day. Even though I receive a large number of take home bottles, I am not allowed to change the dosing frequency because if I have a call back for a bottle verification, everything must have been taken as ordered. Taking methadone q day keeps me out of withdrawal, but it seems that after 8 to 10 hours my radiating leg pain begins to return and lasts until my next daily dose. The expense of clinic attendance is also excessive, which I must pay out of pocket, whereas if a primary care or pain management physician could prescribe the medication, I could pay much less or be covered by insurance. I guess my question is twofold.. first, is there any history of patients with a history of methadone clinic attendance being taken on by regular prescribing physicians if they have been compliant long-term and also present with legitimate pain issues? Second, if leaving the clinic is not feasible, is there any way to work around once daily dosing to get better pain relief without violating federal or state guidelines? I live in West Virginia if this is relevant aside from the fact that the area is very rural and aside from the WVU medical center in Morgantown, there are no large clinical institutions like what would be found in larger cities. I appreciate your time and the excellent information and mathematical formulas you and your team have worked out for opioid conversions involving methadone. Being a practicing nurse in the 1990s before sidelined by back injuries, I can understand how rewarding it must be for you to provide such an innovative and helpful service for those suffering from pain. Thank you.

Is there any history of patients with a history of methadone clinic attendance being taken on by regular prescribing physicians if they have been compliant long-term and also present with legitimate pain issues? It is against federal regulation for a physician that is not certified to prescribe methadone for “maintenance” of opioid use disorder to precribe methadone for this. A non-vertified physician can in fact prescribe methadone to treat pain. if your doctor has clear documentation of a pain disorder, he/she could prescribe methadone in 3-4 divided doses per day basically using your current daily dose and splitting it up. BUT, it would need t be made crystal clear in the chart that your doctor is treat PAIN, not opioid use disorder. It’s a very fine line that many doctors do not want to walk, but it would be legal if handled appropriately.

Second, if leaving the clinic is not feasible, is there any way to work around once daily dosing to get better pain relief without violating federal or state guidelines? YES. You can have a frank discussion with your providers at the methadone maintenance clinic and discuss the dilemma. They are not required to write a prescription for maintenance once daily, although that is the standard of care. Just as outlined above, the docs in the methadone clinic cannot prescribe methadone for pain, but can prescribe for maintenance. Essentially it is the opposite of above. It is my personal belief that in a patient with a dual diagnosis, the law should allow for collaboration between the two clinics, but it does not.

Thank you for your answers. I was not aware that maintenance prescriptions or orders could be more than once per day, since as you mentioned the standard of care is for once daily dosing, and all clients I have met also dose once daily. While hospitalized a couple years ago with an acute exacerbation of ulcerative colitis I was given IV methadone for maintenance three times daily due to me being NPO, but I imagine there are special rules for hospitalized patients after the hospital verifies the patient’s status and dose with the clinic. I do know that I had little noticeable back and leg pain during the 10 days I was treated that way in the hospital, but it is also possible that I was not noticing it due to the acute illness I was dealing with. There was a big discussion, though, about the conversion from PO to IV methadone, with the resident who was prescribing wanting to give a considerably lower dose than what the pharmacist recommended. The pharmacist felt that the PO to IV conversion was much closer to 2:1 or even 1:1 than the doctor who wanted to convert similarly to other opioids like dilaudid or morphine which are absorbed much better by injection than orally. The pharmacist’s recommendation was eventually followed after the attending physician also got involved, and I never dealt with any withdrawal issues during conversion, so apparently she (the pharmacist) was correct in her assessment. Is this also a complicated conversion process, when it is necessary for a person normally on oral methadone to take injectable methadone for some reason?

Travis, Glad to here the pharmacist helped. They are generally more expert at opioid conversions compared to other clinicians. NO, the conversion from oral to injectable methadone and back again is a piece of cake compared to converting to/from methadone with another opioid.

Hello,
Just a suggestion for Travis. Go to your clinic and ask them to do a Peak and trough . This will help the doctor at the clinic see when your high and low is with the methadone in your blood. As far as clinic doctors not being able to prescribe for pain, I know that’s the way it used to be. Since this opioid stuff started happening the doctors at my clinic have now begun to take care of the addiction as well as the pain. AS LONG AS ITS DOCUMENTED. I know this because I have been on methadone my self since 2002. Been clean ( only what is prescribed to me) since 8/19/2005. I have 3 herniated discs and arthritis and I have 13 day split takehomes. I was given a split because of my back pain. I take 65mgs in the morning and eight hours later I take another 35. It may be different in West Virginia but here in Rhode Island they have loosened up on the clinics prescription for pain. I hope this helps and good luck to you. Dr. Fudin thank you for all that your doing with helping people with opioid addiction and pain management!

I live in Florida and am on 160 mg of methadone and I am moving to Tennessee and I did not have time to taper off because the move happened quickly because Tennessee you cannot go higher than 120mg so they said when I get out there they can’t give me more than 120 so am I going to have withdrawals from going down to 160mg to 120mg in one day they said they can do a peak and trough test but that cost money and the bencheley within the week they can have me up to 160 if the test says it’s okay what I would like to know is am I going to have withdrawals badly or just a little from going from 160 to 120 in one day

Patrick, It is unlikely this will cause withdrawal and if it does, it should be mild. I suggest that you ask you doctor to provide colonidine or Lucymera on an as needed basis to blunt the withdrawal symptoms if they occur.

My understanding on methadone blocking other opiates is that the receptors are full. Doesn’t block other opiates Why would you want to take other opiates when on methadone anyway?!?! Seems like playing with Fire.

Methadone does not block other opioids. Adding other opioids to methadone adds more opioid activity and could be dangerous and even life-threatening, and should NEVER be done without the oversight of an expereinced prescribing clinician where methadone is being used for chronic pain management.

Then according to you, my pain doctor could very well kill me! I have been on Methadone for 30+ years and I have not been successful in getting of it. I am a chronic pain sufferer. How do I get this information to my doctor? My email address (thomaskidd52@gmail.com). Thank you

I’m also a chronic pain sufferer- I was on 30 mg of methadone daily for years and 40mg of Opana- until I changed to Medicare- I stopped the methadone cold and switched it with 30 mg morphine sulfate ER 2 daily and for breakthrough pain I switched to 10 mg Percocets 3x daily…You can make the switch- I just messed up my getting Tylenol in my pills –

I’m on methadone I missed my dose an the take home we get for Sunday buy Sunday night I’m gonna be feeling bad I got 130 morphine I had saved just Incase of a emergency I guess it’s ok I just don’t want to go into withdraw ??

When I was on methadone I could miss two days and be just fine. Maybe slightly a bit less patient and it took less to make me angry but no physical withdrawal symptoms at all. It honestly depends on a few factors. How long have you been on it? If you’ve been on it for at least 6 months, you shouldn’t experience any of the normal withdrawal symptoms. However, I have heard of people dosing one morning and they are sick before they get there next dose the next day. I could see that happening if you’re a new patient but not an established patient. Our minds are so powerful and can trick us into feeling bad and sorry for ourselves. I personally think you will be just fine darlin. I was on 175 milligrams of methadone and could miss two days in a row and not dose until later in the morning on the third day. I’ve been off methadone for five years now and if I could do it, I promise so can you. It wasn’t easy at all and it honestly took almost two years before I felt good again but now I feel amazing. Even better than I did in my early 20s. When I started weening down I started “clean eating” just google it and you can learn all about it. I started going to the gym every morning so my body could get use to releasing
dopamine on its own. I started changing all my bad habits to healthy habits. Now I lead a Cross Fit class three days a week and a Yoga class twice a week. I look better than I did in my teens. My body is toned and healthy. I take supplements to help my brain because since I’ve been off the methadone I am very forgetful sometimes. For example, I can put my phone down and a few minutes later forget where I put it. You won’t truly realize how much damage the methadone has done to you until you get sober. I speak to women and mothers who are on methadone or heroin at a center on Tuesday and Thursday nights. When I stand in front of these women most of them stare back at me and they look broken, they don’t think they can quit the drugs and they don’t think anyone cares about them. Well I make sure they know that I care. If I didn’t I wouldn’t come every week to speak in hopes I got thru to just one person. Of course I would love to reach all of them but I’m a realist and I know that none of those women will get help until they have hit their own personal rock bottom. Most of the time after I speak I can see some hope coming back into these women’s eyes. They saw that if I can get off the methadone and have a good productive life they can too. I’m not special or any different then anyone I speak to or anyone reading this so I promise you, if I can do it so can you. It’s not easy, not at all but when you finally break those chains you will have a new lease on life and you will start to love yourself again, you will be proud of yourself and you will respect yourself. I’m going to leave my email address for anyone that wants to talk about getting off methadone and for anyone who just needs to talk about life in general. If you chose to email me I will tell you more about myself and how I ended up on methadone and all that jazz lol. My email is jsiskey10@icloud.com

Jennifer, Thank you for your encouragement. The reason that some people have withdrawal sooner than others is not limited to dopamine release. It is a factor of how long methadone stays in the body, and that is extremely variable among populations of people. The half-life of methadone varies from 15-60 hours, up to 150 hours. The variable half-life easily explains this disparity among and between methadone users. Some of that is explained in this scientific article, Mathematical Model For Methadone Conversion Examined.

Hi, I’m not good at this. I enjoyed your post and I’m very proud of you and your amazing life n self accomplishments WOW…. MY daughter has been on the methadone since 1998 and heroin year’s before that. We have lost our family to drugs. I take pain meds but I’m afraid of methadone because of all the death’s probably from the half lives and mixing other drugs..I would love to hear your story. God’s blessings to you and family.

I have been on methadone for chronic pain over 15 years and tapered from 120mg to 60mg over the past year with my doctors approval. My goal is to try to eliminate opiods if possible.
Due to an arythymia my doctors PA titrated me off the 60mg methadone to 2-15mg morphine daily with 2-15mg immediate release for breakthrough pain. Im now on a pain rollercoaster with releif only if I take immediate release close together. The only other meds i take are thyroid, cortisone, welbutrin and baclofen.
Im almost certain its methadone withdrawel or an incorrect morphine dose. Please explain how to apply the MED formula to be able to converse with the PA using data vs. my complaints.
Is there a way to “flush” methadone out of my body or shorten the duration of these symptoms? Could another medicine be used to alleviate what feels like bone crushing pain until i adjust?
Thank you kindly
Dee

Dee, This is too complex to answer via this forum. You PA may contact me directly. The short answer without getting into opioid conversion specifics is that YES, there are drugs that can blunt or eliminate withdrawal symptoms. Examples include clonidine or Lucymera.

Hey Jeffrey, just lying here sick as I ran out of my pain meds My Daughter has taken methadone daily for the last 20 year’s. I’m Leary of it.I know I’d saves lives and if not taken as directed can take one’s life too. Question. How much methadone would one start off with if they took 50 mg of oxycodone daily for many year’s? P

Please don’t do that, as it could cause death. You need to contact your doctor. At the very least, he/she can prescribe medications to prevent withdrawal such as clonidine or Lucymera. See If you are forced to stop opioids.

i have to disagree about opioids causing tooth decay. I’ve been taking 60 mg of methadone and about 75 mg of oxycodone everyday for about 12 years now, plus 4 other drugs and lately my teeth have just started falling out. This past Friday, one of my front teeth just fell out of my mouth. My other teeth are literally crumbing to pieces. I did find scientific studies on the net that show that methadone as a direct cause of tooth decay, but very little on oxycodone. I have always been extremely dedicated to taking care of my teeth my entire life and literally day before yesterday one of my other front teeth just fell out of my mouth. I just about started to fricking cry. I’ve lost two others in the front and I have about 4 more in the front about to go, and i have 5 or 6 cavities on my bottom teeth. I met with my pain management doctor last Thursday and, of course he denied any severe adverse effect from the opioids as a cause of tooth decay with the exception of dry mouth. But even dry mouth is not normal, it is a direct result from having to ingest opioids. I’m only 58 and am facing probably 10 to 15 thousand in expenses to repair my teeth. I haven’t been able to work since being injured nearly 20 years ago, so I’m sure that gives away an indication of my financial situation. I definitely do not want to have to wear dentures at such a young age. Every single person I know who had to try them couldn’t wear them because of the pain from the inability of them to fit properly. This past Friday, my pm doctor called and sent me a small check to help me pay for my teeth problem as I guess in hindsight he may have felt a tiny twinge of guilt. That small check wouldn’t even cover fixing one tooth. I’m can’t read his mind as to what triggered that act of kindness, but I do appreciate it. He is actually an awesome doctor and I don’t really blame him but I just wish someone would have warned me about the increased susceptibility to tooth decay from ingesting these damn drugs. I need a miracle.

I’ve never seen tooth decay from opiods, but there are several other drugs that are commonly taken by patients with chronic pain that are more likely to cause this problem. Gabapentin and pregabalin are examples. The other most common drugs that cause this are any drugs that have what is known as anticholinergic activity, all of which decrease saliva production. Saliva is a necessary because it kills bacteria and keeps the natural balance of bacteria in the mouth in check. These drugs are most of the antidepressants, but especially those in the class of tricyclic antidepressants – these are the older ones like amitriptyline. There are many other drugs that do this too. Some examples include hydroxazine, diphenhydramnine (Benadryl), orphenadrine, cyclobenzaprine (Flexaril), quetiapine (Seroquel) and many others.

This is not a question with a simple answer, and there really is no good answer, as each patient is very different with methadone and any conversion must be done gradually, not all at once. It is very complex as can be seen in Fudin J, Marcoux MD, Fudin JA. Mathematical Model For Methadone Conversion Examined. Practical Pain Management. Sept. 2012. 46-51.

I am not sure but, I have the same problem.. I have been on methadone for 20 years & OxyContin. 100mg meth & 90mg oc. Since I have been released from the ARMY.. I have had teeth problems and feel like I am not getting enough. People tell me that it gets into your bones.. but I have not had that problem… I am 54 and have had more surgerys then I can count.

I would like to get this information to my pain doctor. I have been talking almost daily Methadone for the past 30+ years and I have not had any success getting off it. But my doctor is beginning to do just that and abandon me. I like millions more am in much pain and don’t know what to do.

What are your qualifications that give you the educational or occupation based experience to offer your comments ?? I have CRPs I and II had been on opiates for 4 years when I began developing cavities at a rapid rate then in 2014 I lost 4 of my front teeth , they just loosened and 2 fell out with not a cavity on them. 2 more fell out after breaking above the root. I’m about to lose 4 more and soon I know I will be toothless. Insurance pays 50% for 1 set of dentures a year. However due to the CRPS that also my mouth and gums have so the pressure of dentures is extremely painful . I’m not able to chew with gums it hurts to much so starting in 2014 when I lost molars I had to change to a pureed diet. Don’t tell me these drugs aren’t linked to tooth loss until you have lived in my shoes. Try asking for a New York Cut Steak Med rare Baked Potato and asparagus pureed. The waitress will laugh at you and anyone close bu will stare.

Your individual case may be true, but methadone has never been scientifically linked to bone or tooth decay. I’ve known people that have been on it for 15+ years with perfect teeth. More than likely you either didn’t brush your teeth enough, especially after eating sweets and sugar that methadone makes you crave.

Russell: “WhAt ArE yOuR qUaL!f!cAtI0n$?”
Everyone: “Well hes a physician & also not responsible for your poor personal hygiene? Take ownership & always remember, if you cant afford to hire a plumber & too unskilled to repair your own sink, the water department doesnt owe you an apology. Have some dignity about yourself, fool!.”

I am a 46yr old recovering Heroin addict, and have been on Methadone for 21 yrs. I’m like you in the sense that I’ve always went to great lengths to take care of my teeth. I have always brushed 2x a day and flossed regularly. It has paid off, and I’ve had very healthy teeth, but the past yr or so my back molars have been getting bad. I don’t have any that are falling apart, but I do have some decay. I have chalked it up to getting older, which I think that is what takes place when you age, please don’t think I’m being sarcastic, because I’m not. I’ve never heard that opiates and tooth decay are related until this post. I do know that Methamphetamine is related to tooth decay, BAD! Anyway, I wish you the best of luck, and I’m sorry I couldn’t offer any encouraging thoughts! Good luck to you!

TOTALLY AGREE WITH D.A. the tooth decay from.using opiates! OPIATES cause dry mouth which like u said is one of the # one things leading to tooth decay &/or tooth loss! I have the same problem as we speak I am 29 years old on methadone for 7 yrs

Over 12 yrs and ur age I think u could Blane many other things, The way u describe one tooth just falling out and others about to do same, then you mention 6 cavities on bottom teeth..Unless this all happened in a day it seems like you maybe could have like millions of us got regular check ups, filings taking care of..I’m not saying I have the best teeth but I’ve never had 6 known cavity at once if so after 3rd I’d b at dentist.That’s why people’s teeth r lasting longer n longer. Yearly checkups.

I myself have had a rapid tooth loss issue since switching to methadone for pain management 4 years ago. I came to the conclusion that methadone itself has no effect on the teeth; however, it does cause dry mouth which leads to rapid tooth decay.

Do what I did. Get all of your teeth pulled out. When I did it, the option for implants were non existent, so I got False Teeth. I have a calcium deficiency, so no matter how good I took care of my teeth it did not matter. They would and were crumbling, falling / breaking off in chunks, etc. The expense to get them repaired was insane, so as they are going, I would have them pulled. I got so sick of the constant pain, not being able to eat, etc, that I found a surgeon who seen how bad my mouth was and knew it was inevitable anyway, so he agreed to pull the remaining 19/20 teeth. Let me tell you, it was the best decision I have ever made. I have had 0 regrets. Nobody can tell they are fake, they are perfect, easy to clean and I NEVER HAVE TO GO IN TO A DENTIST AGAIN (I hate dentists). Trust me, get them all yanked.

That is incorrect. But, as with other opioids, it does decrease hormonal levels such as testosterone and estrogen. With diminished testosterone, it can lead to osteoporosis. Osteoporosis can certainly affect teeth.

BN,, Don’t give up! I know it ‘s uncomfortable , but you can make it. I remember when I came down from 10 mg. from 60 to 30- to 20 and 17,5 all within 10 days. I said that was to fast and went to another Dr. who brought me down 2 1/2 mg a day every month. It made it more comfortable’ and now I am off 6 days The 5th evening I went in for help. I showed them a copy of Dr. Fudin They gave me Dicyclomine, It helps to reduce the symptoms of stomach and intestinal cramping. plus 3 days of muscle relaxers, and trazadone for sleep. I don’t believe, how much it helped I feel 70% better. I wish I had gone in the first day of withdrawals. My biggest problem was upset stomach and cramps. I lost 29 lbs, but the methadone had me eatting unhealthy foods sweets and crap.!! Ask your Dr. if he’s ok with Clonadine for cramping or something in the same family. Take a copy of Dr. Fudin’s feedback. . You’ll look back and realize, that all those years were mostly a blur. You’ll starting thinking again. You’ll make plans, to do those things you gave up on. Please fight it and don’t give up…I’m 100% behind you, as well as do many others, who want to be where you are. Prayers help.

Methadone 100% makes your teeth fall out. It’s actually from the DRY MOUTH is causes. My mom has been on it for about 10 years, and her teeth must started crumbling and all falling apart. She had to have ALL of her teeth removed, and get dentures. So if someone says it doesn’t affect your teeth, they are lying!!!!

Tracy, Methadone had no appreciable anticholinergic activity, which is what causes dry mouth. Common drugs that do that that activity are most antidepressants, certain antipsychotics (ie those used also sometimes for sleep, schizophrinenia, mood disorders), antihistamines, certain anticonvulsants (anti-seizure meds) and certain sleep agents. If your mom is on other medications in addition to methadone, it is more likely one or more of those.

I, personally have been on Methadone for 12 years. Was on 90mg for the first 9 years but have now tapered down to 21mg. 12 years of Methadone everyday and never have I experienced any dental issues or dry mouth. I believe both issues are caused by sugary foods Methadone increases cravings for. If dry mouth is an issue, there are over the counter sprays and mouth washes that help significantly.

FACTS! I had “perfect” teeth prior to methadone and after 5 years at a clinic my teeth are ruined. I don’t care what ANYONE says… I’ve witnessed multiple people complain about losing teeth after being on methadone for an extended period. I was always complimented on my teeth and now I am going through massive dental work month after month to restore my remaining teeth. (Back teeth are gone) The decay is similar to “meth mouth” Methadone seemed fabulous at first after being prescribed ridiculous amounts of fentanyl, dilaudid and oxycodone for years and suddenly realizing how absurd it was and what a serious predicament I was in. (My Pain Doctor is in prison in fact) The trust the doctor thing is highly overrated, especially when it comes to pain management! I actually resorted to a shorter acting “street equivalent” for a year to get off of the methadone before going into a detox. I nor anyone I know would have imagined my life taking such a course. Never was I warned about the serious nature of such medication but rather told I would need them for life! People also say you can’t die from opiate withdrawal! That’s amusing as well! The detox center (paid for high end facility) had to send me to the ER twice. Heart rate was 36 bpm with low BP as well. There are exceptions to the norm with everything! Without medical intervention I would have surely died! I thank everyone that’s commented and all the doctors information on this site. It’s some of the most credible information I have seen online thus far. Prayers for anyone going through the hell of withdrawal and may God be with you if you MUST take methadone. I wouldn’t wish it on anyone unless they TRULY needed it and had no intentions of stopping it. Many may in fact need it… I did NOT! I didn’t NEED anything so serious from beginning to end. I have three herniated discs, degenerative disc disease and fibromyalgia. I have some pain off of all medications but they were worse in many ways while on all the meds. Problem now is while being off of all of the medication I don’t think I will ever feel “normal” again. I have an ongoing inability to feel pleasure from anything at all! If one starts opiates they better do their research first and know the commitment it will take to ever discontinue them. Best of luck and prayers to all.

Methadone does not cause tooth rotting. It causes dry mouth which can lead to teeth issues. Just drink water and avoid the sweets cravings and you wont lose teeth. 224mg a day user. Cinnamon pills also help with sweating.

So sweating is normal? I am brand new. I had been on 16mg of Suboxone and asked to try Methadone. I started on 30mg yesterday and the only thing I noticed was the sweating. :/ And I’m already a sweat monster, lol. And I definitely didn’t feel well last night. I can’t increase till Monday and only by 10mg at a time. And the doc is hard to get in with. Blah blah blah, I know. I will look for cinnamon pills! Thank you. Let me know if you have any more tips!

i have been on methadone for a number of years now, after taking oxy i done as a pain killer from
the street after doctors would not help me in anyway. i was a drug dealer at the time and it’s easy to come by trades, trade dope for pills, make the $ and get my pain away. at one point i was taking probably 15-20 oxy 80’s a day… 270 lbs 6’… when i finally lost my significant other due to pull use i was forced to get clean to get her back. not the best thing to do is get clean for someone else, usually it never lasts when i do it for someone else. anyway… as i progressed through my methadone use i found that the 30 mg they started me on was not enough. being a user and wanting to get back into the “nod” state i kept telling my doctor i needed more and more and he continued to give me more and more. at one point i was on 300mg a day the highest dose in my clinic and my doctor was still asking if i wanted to go up. however once again the “nod” got me and i needed off. so having carries (take home bottles) one week i forgot them at home and was working out of town. the first 2 days i was a sweaty mess but it was bearable. the funny part was i got 0 withdrawals and this isn’t bullshit as i thought it was… so after the first two days i figured well fuck i don’t feel sick i don’t feel anything, just a bit sweaty i can deal with this… day 4 rolls around… nothing still, no constipation, no diarrhea, no vomiting, no cramping no nothing just my regular body pains. day 5 comes around same thing, day 6 same thing. day 7 same thing… i contacted my clinic and told them what was going on and how t happened. i returned my carries to the clinic for them to be disposed of properly…. last thing i need is a kid getting into it and dying or anyone for that matter anyways… when i went to my clinic they asked me some questions and what not and i was th sick at all just still sweaty…. they had me sign a waiver saying that i was taking myself off of a 300 mg dose and that it was potentially life threatening and they explained all the risks to me and that i still wanted to continue with dropping the program. (waiving them of all liabilitys if anything happened to me) i ended up going 5 months with 0 withdrawals, no diarrhea, no nothing. however as soon as winter came around i had to go back into the clinic and resign back up due to the immense pain i was having from the weather change. i am now currently at 70 mg a day and function worse then when i was on 300 so i’m not quite sure how but… yeah… in my experience it was a placebo effect. if you assume your sour, your gonna be sour. i chose not to allow the withdrawals through and it seemed to work. i really don’t know how or why , maybe i just got lucky i don’t know. but i regret going back on it after 5 months of sobriety however the methadone does not leave your system for about a year or so. so your always wanting it for that next year or so after… howeve ei plan to leave it alone after this winter and then be done by. next winter season so i no longer get the cold winter pains

CJ, I’m sorry but I tend to think you got lucky, but only because of my recent experience. I am on 140 mg a day of methadone. I am on methadone for heroin addiction and have been in it for 3 years now. I recently discovered I have cancer and am going through chemotherapy. Anyways, I began to notice after my second chemo treatment that I felt like I was in heavy duty drug withdrawal. I looked up the symptoms I was having, like severe RLS, insomnia, shaking, diarrhea etc. none of those symptoms were listed as part of my chemo. So I started with every medication I was in looking for methadone interactions and sure enough I found one of the meds they were giving me, a steroid, was blocking the absorption of the methadone. So in conclusion I went into withdrawal blind. Thank t had nothing to do with my mindset. I do pray and hope your experience with getting off methadone goes as smoothly as it did last time I just don’t want others to think they are in WD because of a bad mindset. I had no mindset about it because I had no idea I would end up in WD! Thank you for your post however because it does give me and probably others hope about getting off of methadone!
Peace ☮️ Annie

I got diabetes and experienced withdrawal symptoms all of a sudden, i was doing an extremely slow taper for over 2 years, i was on 150 mg. I would go down 5 mg once a month at first, then i lowered it down to 2 then eventually 1 mg every month, sometimes i would take a break to let my body adjust to the taper. Well during a pause and i was down to 32 mg, i hadn’t went down since the month before and i started getting severe withdrawal symptoms, i had stomach pain, twitching legs, nausea,dizziness and lightheadedness upon standing,i felt i would pass out at any minute. anxiety really bad,i kept getting a rush i get with withdrawal, some people get it some don’t, i do often, every minute or two, Dr explained it as my liver looking for medication,it feels like an adrenaline rush kind of but way worse feeling. I got so sick i ended up getting severe pneumonia from it. I told the clinic that i kept getting withdrawal feelings so they started to increase my dose. i kept going up 5 mg at a time and eventually when i got up to 67 mgs they said there must be something causing my symptoms and i had been going to my primary dr and emergency rooms often trying to figure out what was wrong. The clinic nurse suggested going to my OBGYN to have my hormones tested. She is the one who found out i was diabetic with my sugars up in the 600 -700 range and i was at the level where people usually go into diabetic comas. So i started being treated for diabetes, and the pills weren’t helping so they started me on insulin.That is when i finally started feeling better. So withdrawal is not just in our heads. I feel some people are different and are lucky. But for the most of us, we do get withdrawal symptoms. @Anne Maynard So i also think that any illness or stress on the body can cause withdrawal symptoms. I get slight withdrawal symptoms during my menstrual cycle. So having Cancer and especially going through chemo can possibly cause withdrawal symptoms from the stress on your body. I wish you very much good luck with your treatments and hope for a full recovery!

Hi I’m responding to your post because we have a lot in common – with the heroin, methadone, and cancer.. anyways I would like more info on what you said about the methadone being “blocked” by the steroids. I have never heard of that but am definitely interested in getting more info on that whole topic… Anyways if you or anyone else could give me info on heroin-methadone-cancer treatment, etc I would be grateful thx.jc314wpb@gmail.com

Just hang in there your doctor will get you on the right dose. I’m on 114mg a day. Once you get on the right dose you will feel great, I tried Suboxone myself and definitely like the methadone better, I like it way better. I was going threw it myself when I first started but once I got to about 90mgs is when I was good. But ya just hang in there you’ll get there, good luck

Che, This is a very complex question to answer. Buprenorphine could be more effective, equally effective, or less effective, depending on a number of factors. But it is surely a safer option and I have had many patients do better on Belbuca compared to fentanyl or Norco. My advice is to work with your doctor and titration the Belbuca as directed.

My first time and entire time on methadone 3yrs I sweat nonstop could have changed tee shirt 15x if possible no exaggeration ur at very low dose also so my opinion it got worse the higher I went. I also gained 25/30 lbs luckily I needed some weight .I’ve always been told and noticed ppl gaining weight when beginning methadone n staying on it for 3 4 months and it’s noticeable. I could be wrong maybe someone could help. IS IT TRUE WEIGHT GAIN when on methadone is WATER WEIGHT?. I’VE been off and on it for yrs the swearing stopped and weight fluctuates.

No, methadone does not cause tooth rotting, but I lost all my teeth when I was on methadone! My dentist told me it was because I drank such huge quantities of water that I diluted my saliva thus harming my teeth. Apparently saliva has protective properties for your gums and teeth. I wish someone had told me! I would have drank water through a straw, bypassing my teeth (although I guess that wouldn’t do much for the dry mouth) Wahhhh!

Dre, thank you for the tip on the cinnamon pills. You would think after 20+yrs that my body would be use to the methadone, and I wouldn’t have the intense sweating, but it’s not. That is one of my biggest complaints with being on the methadone maintenance program, and I hear it from other clients at the clinic as well. Do you know what the cinnamon does to stop the sweating, just curious? I’ve also never heard of a cinnamon pill, where would I find something like that? But Hey, I don’t care as long as it works! Thank you again:) Shellie

Shellie, as a methadone user myself, i got vitadone from my clinic, or from the website vitadone. Com and it works AMAZINGLY….it controls the sweet cravings and helps u to not sweat as much plus it helps u to not be constipated… i think it would help u alot…the cinnamon pills didnt help me no where near as much as the vitadone did…good luck

20 surgeries on my feet now complete shoulder replacement is recommended at age 56. While I never had the high levels of oxycodone I can say I definitely have addiction issues. I am down to 10mg of Methodone daily and cannot jump off, it is extremely disparaging. I know even though the low dose is supposed to be manageable it has affected my quality of life so much I am starting to get scared. I have outstanding support of 37 years of marriage and great kids. However, they are getting fragile that I want off of the Methodone.

I have gone from a very active focused person regardless of the pain to reaching a point I am not sure there is help. I have lost everything I ever worked for as in my families ability to trust in me providing for them. I have lost focus which is not me at all. I find excuse after excuse not to get my business tended to. We have sold off anything of value just to keep utilities on etc. I am not one to be helpless and I totally pivot to the Methodone as the problem. At first I think it took the edge off of thinking about higher stregnth pain meds, then giving how long it stays in your system jumping off is impossible. The detox people won’t take me as they say I am below the level of detoxing, could it just be my courage is gone due to the long-term use of this crap? I think it’s going on 8 years I have been at this dose. In one regard it seems frutual to keep trying to get off as all the doctors say don’t get off – it’s not enough to be a problem. Since everyone’s dynamic, there is no chance they know what it does to any one person. Any tips on jumping off?

My world went up side down when I injured and fractured my spine and introduced to Norcos hydrocodone 10 mg I started taking 3 pills a day then I started taking 5 pill daily several months later it started getting out of hand to the point where I started taking 18 pills a day and when I ran out of pills I started feeling sick and going through withdraw and feeling miserable my doctor cut me off of norco’s so I had to use other sources to get them so I wouldn’t get sick my addiction got very expensive and out of control so then I started to get help and found a methadone clinic they started me out at 15 mg I am at 80 mg now going to the clinic everyday became a challenge a lot of times I feel hopeless of my situation I tried getting off of methadone I went from 80 mg to 6 mg I started having problems at night going to sleep my nerves on my legs we’re out of and having panic attacks and at times depressed I feel methadone has taken over my life… I think methadone can cause you to have psychological problems they increase my dosage to 12 mg I’m going to have to be very strong and very positive in order to Wing off methadone I heard methadone is synthetic heroin so I recommend to Wing off methadone completely

Im 61 and been getting methadone off the street for a year. I was pn prescription opiates for almost 20 yrs for pain until this gpv. crack down i got pissed i thought they were taking me down to quickly so i took them often and was cut off anyway i found access to methadone after chasing heroin in the tenderloin of SF well the methadone ended and it been 7 very rough days my last dose was probably 15 – 20mg i didnt think it would be as bad as it can be flu symtoms is a crock i never had flu like this it!l make a grown man cry good luck

How are you now, I know i prayed for death to take me for nearly 20 days, Don’t believe the bullshit 1 week my ass. Try to get into a clinic of some kind. hang in there 16 months later i was off that shit too and still clean to this day

Just wanted to to know, I’m 7 days off of 35 mg of methadone after 14 years. Clonodine 0.2 mg WILL stop that withdrawl feeling you’re having at night. It’s not a narcotic and should be easy to get because its non narcotic but it DOES HELP. GOOD LUCK!

I’m down to 24mg after 9 years of being on this crap. Going 1mg a week. Using kratom to help. I also have neurontin, weed, b12, and vitamin d. I was feeling shitty in the morning but now with all that stuff i really don’t feel too bad.

I’ve tapered down from 149 to 26 mgs over the past 2 years. I taper in cooler months to avoid sweating profusely. I go to a methadone clinic & they give you daily doses of liquid methadone. It comes out of a machine into separate daily containers so it’s easier to control your dose & taper. I’ve heard the pills work longer but I’ve never had to worry about it. Liquid lasts for longer than 24 hours for me. Methadone clinics are a pain because they deal with street users so they will need you to go in daily & earn takehomes by staying away from illegal drugs. If you have a personal Dr prescribing it maybe ask about getting off the way I described. Maybe the pharmacy will have liquid & be able to dispense it in desperate daily doses in small containers. This is the best way. Marijuana helps too.
Good luck

I go to a methadone clinic as well i feel if u can smoke pot ull b able to come off my problem is i have a bone disease an i also have hemochromatosis witch causes me to hurt so bad to an then my back got broken an i have to go through major sugery soon methadone saves me from the OTHER drugs i was on cause i was buying more cause what i was prescribed wasn’t helping an methadone helps i would love to stop everything but im in pain everyday wish i had a pain dr who prescribed it instead of the clinic cause they screw u over but anyways i agree smoke pot if u can an colder months is better too good luck everyone

The problem with that is a lot of methadone clinics ( at least he ones that are in states where marijuana is illegal ) don’t allow you to use marijuana. Oh how I wish. Lol. I would love to be able to smoke but my clinic does not allow it.

Sure you can 12 years in one best clinics in my state and now its not legal where i live uet but ive been to several for courtesy doses on vacation and not one clinoc ive seen cares about pot anymore.and thats a fact

I can relate to everything u have said about methadone use and then some! I have been on it for about 7 yrs now. At one point I was up to 95mgs. I’ve lost my families faith, my job, my.friends, my TEETH, gain 80 lbs and worst of all I’ve lost the self respect and the ability to provide for my children that I once prided myself on. Methadone “treatment” has been the worst choice I have made throughout my entire life. I truly don’t even recognize myself anymore!

So, I’ve decided to do something about it. I have weened my way down to 15mg, and as of last Wednesday I have not taken a single drink. It is a poison that mutilate ur MIND, BODY, SELF WORTH, SELF RESPECT, AND SELF PRIDE!! My life has been torn apart by this DRUG. Everything was great while on the painkillers. I was doing to many, but I still got up early and worked my ass off everyday. One of the worst side effects for me is the depression it causes (that and the weight gain).

Anyway, back to what I was saying. I have been slowly decreasing my dose for the last 2 yrs. And each and every time I drop my ‘doctor” work extra hard to bring me down, and convince me it was a bad idea. It’s now been 4 days with no drink, and i do feel a little rough around the edges, but it is bearable. The hardest part is getting next to NO.sleep. all these effects WILL.go away if I stay away from the drug. If I continue using g it I will never be the vivacious, hard working, fantastic Mom and friend I know I can be, the woman that is teed inside me drowning on poison

You want advice on how to quit…..pick a day and just…..QUIT☺ I am not trying to tell u it will be easy, because it won’t be. But what in life worth doing ever really is.

Well, that’s my story. I hope it helped you, aND gave you the curate to fight this demon. One last thing, you WILL need ur family’s help. This is not something you can do on ur own.

This may not be the right forum so I apologize in advance but I trying to find some sound advice for switching from Suboxone 8/2 mg 3X day TO methadone 10mg 4X per day. I have been on that script for 3 yrs after getting off of prescribed 450+mg oxicodone/oxicotin, soma and zanax for chronic pain. After 15 yrs of pain pills due to numerous vaginal surgeries and digenative disc disease I became highly addicted. I have zero experience or knowledge of methadone but due to increased pain from yet another medical problem my addiction specialist Dr told me to try methadone for 1 week and come back to see him. I’m starting this over holiday weekend and am very scared. Everything I’m reading scares me! I’m married 15 yrs have a 13 yr old son and I can’t afford to go backwards. Please help…thank you

I have severe pain that keeps me from being able to clean my house sit upright stand walk out to my car shop for groceries it affects everything that I do. The only medication that has ever manage to do anything for my pain has been methadone. Unfortunately because of the opiate crisis saying they’ve closed down just about every pain specialist within a hundred miles so now everybody who was seeing doctors is now going to the clinic and instead of paying $5,200 for medication we’re paying 400 to 500 dollars. People have a lot of different experiences with methadone but two 10mg methadone one in the morning and one at night take better care of my pain than 80 mg oxycontin 3 times a day. But again everyone is different so you can’t look at what happened for me and think that’s going to happen for you just like you can’t look at what happened to the other people and think that you’re going to have that same bad response.

Methadone changed my life I was on so many prescriptions I lost count and still had severe pain and migraines everyday I couldn’t do anything without my meds after getting on methadone I’m off all other prescriptions and pain free I went from going to the Dr once a week to not going to a Dr except for a checkup! If you follow your Drs advice and have the right dose it’s the best pain medicine you can get!

You can do it! Just kick it with the support system. I’d give anything to have that. You may be pretty sick for a few weeks but it gets better. I cold turkeyed 400 mgs and was sick for a month physically and relapsed 5 months later due to hot and cold sweats. Yes, even 5 months later. My dose was too high. I promise you it won’t be that bad. Do it while you can.

I would stop if I could get that low – you will have minor discomfort for a couple of days … Just do it! I know ppl on 185 and higher who have been admin detoxed at a facility before – they take you from 185 to 0 in 14 days – talking about crazy. I’m on 70, used to be on 120 but decided I just needed enough to help with pain so I got down to 70. I would love to get off but I have the pain issues and love all the other opiates way too much. 10mg though … wouldn’t do anything for me and would be a waste to take at all.

To anyone thinking about ending it because of pain please read this. I have been close to 3 people who committed suicide including a best friend (I dont and never had made best friends easy and I miss him to this day 25 years later), a cousin who I loved like an older brother and my girlfriends brother. 1 did it because he has diabetes back when it wasn’t as treatable if you had it as a kid, my cousin over money and my girlfriends brother over heroin addiction. I also just recently got to clean up the aftermath of my father’s friend killing herself due to pain she couldn’t get treated.

Now a little about my story, in 2006 I drove a snowmobile into a tree at nearly 100 mph how I didn’t die was a miracle or bad luck depending upon how I look at it. I say bad luck because I broke nearly every bone in my body including both my neck and back in 2 spots. I didn’t bleed to death because I was drunk and it was cold. Somehow I didn’t get paralyzed, but since then I have lived in remarkable amounts of pain. When I finally broke down and went to a dr for pain management he said he couldn’t believe I was walking around and functioning for the 4 years after recovering from my accident which took almost a year. I first went to this Dr in 2011, over the following 7 years I ended up on a combined daily dose of 1100 mg of oxycodone and oxycontin. 10 80 mg oxycontin pills and 10 30 mg oxycodone pills daily. In some ways my life was better in others it wasn’t. But my pain had been greatly reduced.

Early this year my Dr lost his medical license due to the narcotic nazi’s aka the DEA. So I was taken off at least a three year 1100 mg dosage overnight basically. No Dr would take me because of my old Dr and script level, which seems like discrimination but what do I know. What I do know is I went through hell, I bit the bullet and went to a rehab place to get on suboxone even though it was humiliating. My pain was through the roof even with the help with suboxone. I’m now off of suboxone and live in constant extreme pain. But I wont end my life or even consider it.

I’m not in love with myself, nor do I fear death. The reason I won’t do it is because I have experienced and witnessed first hand all the torment it puts anyone who cares about you through. If you love just one person in your life believe me the mental pain you will put them through by suiciding is at least a thousand times worse then any physical pain you are in.

If you don’t believe me or think your pain is greater then anything I’ve been through there is a good chance you’re wrong. But either way I do know the pain caused by suicide and you don’t want to do that to anyone who cares about you.

Wow is all I can say , thanks for sharing your story I don’t think it’s fair people like us who were put on meds to help our pain have to suffer because others mis use the mess when we are clearly in need of it I myself was in a accident and broke 62 bones and like you no one knows how I walk around everyday , work , take care of a house and kid by myself as of now I was reduced to 6 10 mg of hydrocodone a day which is better than nothing but still a struggle but they are trying to take that away too I would never take my own life but have no clue what to do to get by daily

Look up Gabapentin. Trust me on this dude. This is a drug for nerve pain but for people who like me just had to get off opiates and couldnt find anything else I finally was able to get on this for Methadone withdrawls and it really is better than nothing. What do you have to lose? Just trust me and ask your dr about it and try looking it up for yourself!

Yea but thier trying to say that those are also being abused now .. and i tried to get on them and was DENIED .. my therapist laughed at me because she prescribes me adderall and said thier was no way she could prescribe me two narcotics .. but the point is they are finding thier place unfortunatly it feels to me like ( a black list ) because of the BAD GUYS out thier that the other poster was reffering to who are being effected by the addicts .. on the same token the addicts are also being denied an option that isnt methadone lol or subozen .. but maby thiers something to that ?? Ive read that neurontins if ur trying to get off one med ( enough to really help u ween ) are also addictive so what to do ?? I think maby it all comes down to being READY period…

Hi
I live in Ottawa On. My dr is trying to get me off of 60 mg Oxy cod one a day. We’re having opioid crisis from addicts overdosing. He’s not trying to replace it either. I’ve never gabapentin being used for withdrawal etc. I didn’t know it was a narcotic. Would you be able to tell me more?
Thank you
Shannon

I have to wonder about your dr. As gabapentin is NOT a narcotic. Its barely even controlled. Please don’t think i am attacking you i am just sick to death of people who don’t understand what pain truly is telling those of us we aren’t that bad. How busted up do i need to be for a doc to say , i bet that hurts and mean it?
Ive been on a taper off methadone for about 3 months. From 90mg a day to 10mg a day. And let me tell you if feel like crap. I recieved my injur while in the service back in the early days of payback for 9-11. And at first was lost, after pretty much everything on the counter was tried, i hate taking pills. Then along comes a doc with a wonder drug, you guessed it methadone. And YES it did better my daily life. Got me off my ass and working again. Even helped with migraines from Post Traumatic Brain Injury. There are a few things I would have loved to know up front… maybe a little note that said” oh ny the way you’re teeth will rot out, and god forbid we try to take you off them.”
But truthfully I would have still taken them because what i was headed for was a more perminent pain reliever.
Anyway i am rambling, but my fellow earthlings, hopefully we all still are, I truly feel your pain. But i have to agree with the above comments this pain we all have in one form or another is NOTHING compared to what we deal to our loved ones when we punch our own ticket. Stay strong help is out here but you have to step up and ask.
Love to all
Karl
( I Don’t Kneel) sry thats going to the gestapo who no doubt monitor all.

Yes gabapentin is the generic name for neurontin. Also what some people don’t realize is that first
Gabapentin is not a controlled substance yet. They are pushing for it though. Also just because something is a controlled substance it does not make it a narcotic. A narcotic is a class of drugs while a controlled substance is just that. A controlled substance.

For clarification, a controlled substance is a prescription medication given categories II-V by the DEA, based on abuse potential. II has the highest abuse potential, and V has the lowest. Schedule I includes drugs that are not approved for medicinal use in this country and which have the highest abuse potential.

Sorry but adderral is not a narcotic and gabapentin is an anti convulsant so I don’t know what your therapist is talking about. I am on a very high dose of gabapentin and unfortunately it does nothing for my nerve pain. It helped for maybe the first six months but coming off is no joke. Make sure you know this before going on— coming off has some withdrawals that aren’t too pretty.

Most likely, her therapist is using the word “narcotic” to mean it is covered by the narcotic (controlled substance) laws. this is often misquoted, and you are correct Laura; it is one of the reasons that we refer to those drugs as “opioids”, not narcotics, because the latter has become a derogatory term and is often misused.

If it’s not with pain involved, clonadine for withdrawal symptoms. You can go into the ER and say that you are getting off narcotics and was told on this site that clonadine (ask for it specifically) works well for withdrawal symptoms.
I am a chronic pain patient, after being run over by a drunk driver, and years ago was abruptly cut off my medication. I was lucky enough to be at Johns Hopkins, and they gave me clonadine for the withdrawal and a referral to their pain clinic. Trust me and the doctor, clonadine and my bathtub worked wonders. This was in the 90’s and I cannot believe that in all of these years–especially with the Internet, addicts, websites, forums, and seemingly medical providers–clonadine is not widely known about and used. Perhaps, if it were, so many people would not have been hitting the street and this opioid crisis might not be what it is– including making life very difficult for legitimit pain patients, like myself.

Antidepressant are being proven to not work and cause even worse withdrawal I know because I was on them all and it is hell. Opiates work for me and nothing else. I was only on 65mg a day and they have forced me to 40?mg a day and it’s a living hell. I have a job and two young daughters my wife is exhausted trying to pick up the slack of what Ivan and can’t do. The DEA is a bunch of puppets for the drug industry period. Try medical marijuana or cbd. Try Kratom too

Dr Fudin, I had been on 60 mg of oxycodone, and 30mg of morphine for 12 yrs. Same group, but new doctor took over for my doctor who relocated, and changed me to 10mg of methadone 2 times a day,and 2 -10mg of hydrocodone. 1 yr later,Now there’s a new doctor, who said he doesn’t like methadone, and would have never prescribed it,and wants me off of it. I’m still in a great deal of pain,but I deal with it doing chiropractor,deep tissue massage,and physical therapy every week. I really never knew what methadone was,because i had never been prescribed it. Everything I read though, and hear,methadone is a terrible medicine. What medication could take place of 20mg of methadone everyday? Or should I stay on it? I appreciate your help Dr Fudin. Thank you

Good luck everyone. I think talking to someone that knows what we’re going through helps,like this discussion group.

Kelly,
Methadone has many attributes that other opioids don’t have, but it also has pitfalls, especially with regard to drug interactions and other risks. It’s hard for me to answer your question without knowing your entire medical history. And even then I couldn’t give that dirt if advicd here.

Yea thanks for sharing your story. Im on 70 mg of methadone and it works pretty good. Not nearly as good as that awesome1100 mg oxy script. Suicide is all bad for sure. Rip to your friends and Anthony Bourdain and anybody who has ever been effected by suicide or addiction and homicide. Be safe !

Just to add a little something 2 previous post. .RIP 2 ur friends…Please be safe & take a second 2 think as bad as it gets or is ,,sun will come up tomorrow…suicide should never be a option. Life is beautiful.and if ur down or ur bottom. . well then there’s no place left to go but up.I struggle every day with addiction 4the past 20yrs.. but I try to fight as much as possible. ..

Dave that was a remarkable heart felt reading. i too was in a terrible crash only on a motorcycle and broke 9 ribs, shoulder ,clavicle ,wrist.closed head , spine fx,trauma,collapsed lung and oh yeah a comma x 2 weeks. i am now after 15 years of oxie levels near yous then switched to 800 milligrams of morphine for the last 5 years along with 9 dilaudid #8 per day. now that we have the opiod crisis they have lowered me to 200 mg and getting lower each month. my first dr, retired sorta , he kicked all high dose pt. to curb.dr. number two continued my care but got arrested trading scripts for sex. dr number 3 , my family physician kept me going for another year until the practice stop writing for chronic pain opioids.with luck dr. number 4 took me in at a pain clinic was very sympathetic but said he legally had to lower doses. i did not notice the initial dose lowering s as bad until down to 400 mg now i have been up all night in serous pain and really feel like i am detoxing bad, I had a coworker whose husband killed himself due to pain that the insurance co. would not treat except with an internal electric stim on spine, he shot himself a week after it was installed. my coworker was crushed ,but said he was in so much pain she knew something would happen, pain really sucks writing this awaiting my dr office to open, hoping he may help i have never asked before . people do not deserve to live like this but as long as politicians are willing to trade our pain for votes were doomed. peace out

Hi there Thomas! I am curious about the doctor you mentioned that got arrested for trading scripts for sex, because funny enough mine did too. I am curious if you live in the same state as I do (Indiana), and if we had the same doctor…? How crazy would that be? But when you mentioned that I thought “How many pain docs are out there that have done that?”. I finally found a great pain doc, although that’s not what he goes by. He is listed as a Opioid Management Doctor, and their office is listed as “Opioid Management”. Thet do things differently that a typical pain clinic, and they dont treat any of their patients like addicts.

I go to a pain management clinic and have been there for years at the same 60 mg of methadone for my severe pain. I have never asked for an increase with my pain medication. I also take gabapentin and cyclobenzaprine PRN. I went to my usual monthly doctor appointment and out of the blue he said he is taking me off of the methadone and switching me to oxycodone. I told him I would rather not make changes but I did not have a choice and he took me down 10 mg per month from the methadone while switching me to oxycodone 30 mg. I am up to 4, 30 mg tablets per day and he said that is where I am going to stay with now zero methadone I have never been going through more extreme pain in my life. This doctor who is really a physician assistant seems to have problems when he’s trying to do this equation trying to give me enough Oxycodone to the equivalent of the methadone I was taking but I can honestly say there’s not a snowball’s chance he is even close because I have never had pain like this in my life. I have been to the ER twice because of the pain severity and as anybody knows who is on pain medicine you cannot get any help when you are already being prescribed by another physician. My question is does anybody know what the equivalent is of 30 mg of Oxycodone to 60 mg of methadone? By the way when I asked the doctor what is the reason for all of this change? Each time I went in there and he told me something different and never gave me an honest answer.

Dawn you may be better off to go to a Methadone clinic. Go there and say you are addicted to opioid’s, even if you aren’t. They will put you on the methadone you need. If what they give you is not enough you just tell the methadone clinics Dr. you are still having bad cravings and withdrawal and they will up it. I started at 30mg when I went there for abusing Ultram, and I am now on 95mg of Methadone. Ultram isn’t supposed to be addictive but the Dr. had me on such a high dose I had terrible withdrawal, I couldn’t get off the shit. The I got pregnant and knew I had to get off of it. I tried all the rehabs first so they could taper me off the Ultram but none would take me b/c I was pregnant. The only one that would take me was Methadone clinic. They said if I just went cold turkey off the Ultram I could miscarry and they told me the methadone was proven safe for pregnancy. I am an addict, I crave that feeing of contentment you get when you are on pain meds. However I will never go over the 95, I am in the process of cutting the methadone down using Gabapentin , but now they are starting to say Gabapentin can be addictive, I swear you can’t win.
But anyone in enough pain you will have more luck going to a methadone clinic then a regular family dr. they are so scared of the DEA.

Wendy,
I would NEVER refer anyone to a methadone clinic. As you, an addict , are well aware, Methadone is one of the worse meds to get off. I would suggest Dawn stick out the meds they are putting her on until she is able to start dosing down regardless of how long it takes.

If you really want off Methadone, Why not ask your doctor to switch to oxycodone Instant release formula , And then slowly wean down by no more than 5 Mg per week or less even dropping 10-mg per Month. If you have the will power to step down slowly

Actually, Wendy was just trying to be helpful. If you read Dawn’s post you will see they changed her from methadone against her will and didn’t tell her why. Dawn isn’t necessarily trying to get off the opiates because now that they changed her meds she is in more pain than ever which is why she has been going to the ER. She’s using the methadone for pain not addiction and methadone tends for many people to be a much better pain reliever than oxycodone, which is why Dawn is experiencing much more pain. So it’s not about getting off the opiates but about finding something that will work for her. The methadone WAS working but now they changed it. So if they are unwilling to put her back on it she should either try to find another doctor or yes, actually go to a clinic. I know clinics stink but if it’s about having a life, I would rather be on a narcotic and experience some pleasure rather than be completely off and have no life due to horrible, intense pain. Trust me I know all about debilitating pain that makes you completely unable to experience any semblance of joy. And going to the ER generally does not help at all.

Every where I go’ I feel they think I’m a drug addict…40 mg methadone 3 times a day for 16 years’ then Jan 2016 doc said I have to take away your zanex and start lowering your methadone to some new standard. well got me down to 20 mg 3 times a day and I started having trouble, couldn’t do much around my home and yard // complained about it. then received a letter from doc saying I failed a drug screen for pot and he would not give me anymore pain meds’ I said no way take a hair sample. but he would not even reply to me… This last year has been hell and so much pain and street drugs’ now I found a doctor but he insisted on a back stimulater. which was a week of hell’ then the 1st of Aug they took my now down too 10 mg methadone 3 x a day too 3 1o mg percocet a day… I called Friday and told them it wasen’t even close I’m taking a 10 perc every 4 hours just not to think about killing my self’ I’m 57 and have been here long enough’ it’s just not worth the fight anymore’ I’m going in Monday to see what they will do’ hanging in there but don’t really care anymore’ sorry for rambling if anyone see’s this //

Please hang in there. I know it’s a hard fight but you and your life are worth the fight. Try looking up new pain management clinics or services if there’s a methadone clinic near you. Please don’t give up. You’re a strong woman. You’ve made it this far for a reason. The storm clouds will pass and the light will shine through.

Wow that’s terrible. My doctor told me methadone is approximately 4 times stronger than morphine. So if you were taking 60mg of methadone then that’s approximately 240 mg of morphine or slightly more. This conversion barely worked for me. I’m on 30mg of methadone from a pain doctor and he briefly switched me to morphine and gave me 120 mg(60mg twice a day) and it just barely help me. I did have withdrawals and could have probably used another 20mg to keep all the withdrawals away. I read that 100mg of morphine is equal to 65mg of oxycodone. So if you were taking approx 240mg of morphine, that’s around 160mg of oxycodone (maybe a little less due to the conversion) but I bet you would actually need more than that. Methadone is a much stronger drug than oxycodone. My doctor offered to switch me to oxycodone— that was when he also offers the morphine— I said hell no to the icy and changed to the morphine because I knew the oxycodone would not hold me and the pain would break through like never before. I believe the pain relieving properties of methadone are much stronger than than oxycodone. You should try to find out why the switched your because that’s just wrong. Did you have a problem with an EKG or something?

Dave, Thank you so much for your story. It came at an appropriate time. I am at wit’s end with pain and the psychological traumas I’ve had over recent years would be enough for most people to have ended it. I don’t have any close friends, though I have two family members and my faith. God has always helped me at these times and I feel he is waiting to help me now. May God bless you too. Oh, the one suggestion I give everyone is to have a whole arsenal of options to help with pain. It will help.

Thank you for your input. I have been suffering severe pain that is unbearable & with the supposedly opiod crisis. My treatment is so low I am always in unbearable pain. I as well am not aftaid nor fear death & the only eeaaon so far dor not biting a bullet is the repercussions to the living. I have several severe herniated vertebrae that constantly pinch the nerves, discogenic disc disease, OA & RA, retrolethesis of all lumbar vertebrae on & on. I really think with Baby Boomers becoming older & influxing the medical insurance agencies, social security, medicare, etc is the only reason for the supposed opiod crisis. As tylenol 3 was never considered an out od context opiod. It has been used to teeat arthritis pain, lower back pain & because the government & state want to save $’s whether than compassionately treat the aging populace. Shame

My mom and best friend committed suicide and it sucks. My son has been trying for years now with heavy use or misuse of many drugs.

With that being said…. I do get tired of the pain. I have Lupus and just get tired of being tired and sick…. and pain left from spine surgeries….

What throws me over the top though is when our stupid government comes up with new changes that hurt so many innocent people.

I have been on 20mgs of percocet for 5 1/2 years. I have never abused it or taken more. Now because people have abused it and been over prescribed…. even those of us who have fought so hard to stay at the lowest dose possible are being told No… it is not good for you… it is deadly…. it is seriously addicting.

Seriously has anyone ever died on 20 mgs of Percocet? Now they want to start me on something called butran patches…. No thank you! long lasting… great so when you decide to take that away I get really long withdrawals.

I am 56 and feel like sticking my head threw the wall…. it wont kill me but might knock me out few hours.

I admire your strength to hang in there and deal with your pain. I cant believe you were on so much medication. It is horrible that other doctors will not see you because of what your last doctor did. That would be your fault how?

I use to trust doctors and now I do not trust them or our government at all.

I’m kinda in the samefix . I was on 190mg . Of methadone and got down to 70mg. I moved to Florida and boom they don’t give anything without pulling teeth. I had to get all new x rays and cats , get on a pain clinic and they cut me 10 mg. A month. They tell me that the law says only 35 mg daily but I get 40mg. Now they cut me by half , 20mg. A day and 20mg. Of oxycodone. The only thing that it does is bring back my spine pa I suffer

Hello Dr. I am another who has taken methadone for pain. I have stayed on the same dose (70mg) a day for 9 years, unfortunately my doctor (who was an amazing man) just passed away and now I am having unbelievable problems finding a doctor to “take me”. Finally I had to go to the E.R. where I had an incredible doctor who just looked up in some pharmacy database where it shows I have been taking the same dose, same doc etc, he said “do not stop cold turkey, you may die”, and gave me 10 days worth. I am now on my 9th day, still haven’t found a new doctor and I am crying because my next option is to have to drive 2 hours to the nearest methadone clinic where I have to say I’m an addict when I am not, just to keep from possibly dying. Also I have brought myself down to 30mg during this ordeal. My pain is worse, but I am still alive. I have children, grandchildren, a job, a house, animals all that need me. I wish the CDC had statistics on how many deaths are being caused by their recommendations! What is the real reason this is going on? Someone told me hospitals have been having shortages in injectable pain meds more than they’ve ever seen?! I feel for all of you with similar stories. My life was good for awhile so I’m at least happy about that, I just hope the pain never gets the best of me now. But sometimes you think death would end the misery. I hate politicians who think they know better than doctors and patients on how our healthcare should be managed! Evil evil people!

I am on 150 mg of oxycodone a day and my doc wants to switch me to methadone for the reason ” I’m trying to look out for you it’s cheaper, as I am self pay but tomorrow he wants to give me 120 mg of oxycodone a day and I think ,5 mg of methadone a day. Is this a problem?

Teresa, Without knowing your entire medical history or seeing you as a patient, I cannot comment on dosing. It sounds like your doctor has a plan. If methadone is an appropriate option, it generally be introduced at low doses very slowly.

Thank you for your response. I can’t believe you are alive! I wasn’t in a severe accident like you but almost four years ago I came off Prozac and for some reason it had a profound reaction on my body. 8 weeks later I started to experience bad pain on my face…at first in just small areas. Then after three months it was my entire face, eye lids, eye balls, lips and gums. They burn and sting constantly I mean all damn day. I couldn’t talk, eat laugh or cry. I had to stop working and move back in with family. They had to blend my food in the blender to sip through the straw. I baffled doctors… they all agreed it was a severe form of nerve pain like trigeminal neuralgia. Trigeminal is a horrible facial pain condition with one of the highest rates of suicide but it generally only affects one area of the face. My condition didn’t make sense because it affects my entire face and my eye balls constantly burn to the point where my vision is blurry and keeping my eyes open just hurts to the core. It’s like I want to take a knife and stab them.
I understand about your doctor losing his license— he could have killed you and was way over prescribing. A similar thing happened to my best friend— her doc was giving her 250mg of methadone, 10mg of Xanax and 180 mg of morphine. I used to tell her constantly that she was way over medicated but she wouldn’t listen. Finally the DEA stepped in and she was cut off. So she went to a clinic. However a new doctor should have worked with you given your condition and what your poor body had been through. You were clearly in a lot of pain. It’s good your off I guess but your pain must be so bad. In my state the laws have been totally changed as to the dosages you can now receive. I go to a pain clinic and my doc gives me methadone but 30mg is the MAX. Other stares will soon follow as 90mg of morphine is the max and it’s equivalents to other opioids like Vicodin etc. it’s going to sweep the country but it’s taking some states longer. The methadone helps me so much but I desperately wish I could get a slightly higher dose to be more functional. Before the methadone I couldn’t do anything and was bedridden for 7 months as I tried all these other meds that did not work (non narcotics). I mean I tried everything. It was only after trying everything that I was offered the methadone and I jumped at it because as I said I had no life. At least now I can get out of bed and shower and do small things in my home but I don’t go out much and during the winter I can’t go out at all because the pain is so bad. If I have to go out for an appointment I have to wear a mask. But I could relate so much to your post because I constantly think about taking my life because the pain is so much to bear. I feel like I have no life and as though my life is meaningless because I don’t do much. I can’t work and I barely socialize. Are you very functional? I just wish I could so more. Sorry if there are spelling mistakes it’s my darn phone. Thanks.

I’m having similar thoughts as Danny and I’m sure many others are abt ending things BC of my pain. And the fact is so many of us are treated terribly. Its a tremendously harrowing experience to be cut off of your medications. My current pain Dr. is prescribing 2 5 mg hydrocodone/day when I’ve been on a dose of 180 mg morphine. He took over for a doc who left. Now BC by the time I got in to see him my morphine was no longer in my system he refuses to prescribe it. I am now spending all my money buying morphine on the street. I’m having to panhandle just to keep out of pain. I don’t know what to do or where to turn. I can’t seem to find a Dr. who is willing to treat my very real pain. I’m on disability, fixed income. Even if I have to pay cash to a pain Dr. would be fine. But to pay one and get nothing is breaking me. He doesn’t care at all. I just don’t know where to turn. That’s why I was looking into methadone clinics. BC maybe it would help my pain. I hate the idea of having to lie to get pain relief and really I don’t want to go on methadone and have to go in every day. I’m not an addict. I’m in pain and I need medication. Why can’t we get what we need? Why are good people made to feel so horrible and worthless. It’s too hard and I don’t see an end. I’m in the bay area. My email is kjstauffer59@gmail.com if anyone had any ideas. So sorry for any of you out there who may be experiencing this much pain and discrimination and hopelessness.

I take 160 mgs of methadone daily, and it’s a nightmare!! I Doctors, Pharmacy s , people who DONT have pain,I feel ya, and I understand. I live in North Michigan, I drive 3 HOURS TO APPT EACH AND EVERY MONTH! I’m ready to take my own life, because this isn’t life 3 surgery s 6 discs removed, I have severe dergenative bone disease.Everybody thinks your just a dope fine Good luck
Dean

Dean. Dean, hi. Please. I know I dobt know your individual pain. I can say that I’m very much able to relate as far as our “alike” surgeries and life long injuries, DJD/DSD/DBD. I was taking 180mgs avinza (time released morph caps) and then 15mg perc 3x’s p day for breakthrough pain. Id been on the same exact dose of morph for 12+ yrs.. It, naturally was not working so well, fair to poor. Backing up, I was taken off the breakthrough meds when i went to new pain management dr bc his P.A was playing God and literally throwing records away. That being said, mine were never seen and the dr discontinued them. 2 yrs later this pain dr couldn’t keep his hands and mouth to himself. Bye bye now you dirty rat bas….. Sorry. So here we go to a female pain dr.. Each visit the assistant asks, is your pain medicine working good fair poor…. I Kept replying, “poor to fair”. I asked dr her thoughts on a “medication vacation” . She agreed, we transitioned in 2 months, tapering the morph and introducing meth. You know this Chinese ancient dr refuses to manage/control my pain properly, as she said we would increase to 1-2 addtl doses per day. Providing me with 30-40mgs p day. Well she had a bit of a, shall we say a Freudian slip! Yup! First she plays on people’s pain and emotions. Says (although shes had no injuries or such) “oh my neck far wurse din yours and i no take no (deep long voice) pill. You disabled and no work on Medicaid you not take medicine only when you want bc people sell…… I kid you not! Shes also refused to continue my muscle relaxers for continued treatment of the aboved mentioned, fibromyalgia and another muscle disease. I was involved in a single car MVA and went misdiagnosed with a broken neck for 20 yrs.. By now…oh gaed! The damage is irreversible and so severe its left me unable to use my upper body. So spine specialist, surgeons and all the other this n that specialist, failed procedures injections and crap, 25 yrs later we FINALLY found a regiment that controlled my pain enough that it increased my quality of life by 60% and then you have my pervert and this off the hook & crazy pain dr thats playing on people’s pain and livelihood. So dont give up! Youve come waaasy to far. So…please help me to understand your input here. Were you previously on different pain meds and they converted you or youve been prescribed the meth all along? That seems like a truly high friggin dose. I dont know you and im concerned to hear you say you’re taming such a high dose. So if its creating this crappy quality of life please express to them that you need to transition to something thats going to better manage your pain. And explain to the dr how it makes you feel. I hear the desperation for help/relief in your “voice”.. Please. Perhaps get a referral from your PCP for a new pain management doctor. Call around and ask, if they take your insurance and do they prescribe. Idk what else to offer and I know im no help here. Just know youre not alone in the daily anquish. I know we’re kinda on opposite ends but its the same. Im really grasping for some helpful and useful positive words to share with you and wish I could offer hope. Just dont you EVEN give up and become a statistic! Become your health advocate. Call your insurance company. Idk.

Hi Dean and Kelly
You need to taper down as your dose is way to high, I have had 13 ortho surgeries and six fracture including compound fracture in 3 places at 12 years old. I switch to methadone 20 years ago i am 54 now, been on painkillers since 23 years old. I just had shoulder surgery and knee surgery April 19th 2018. Im telling you this so you know i am/was cronic pain. I believe you have real pain and understand your dark thoughts as I have had them too. I have tapered down to 4mg of methadone and have no constant pain ( i do have arthritis and tendonitis so it flair up but learn thats certain food or activities make it worse) which I am very happy about.
when I was on Vicodin my moment of awakening was watching a movie called Beautiful Minds with Russell Crowe, It is then I realized it was my Brain tricking me into thinking i had pain when I really didn’t. If you watch this movie it will make you look at this possibility. I am not doubting you have real pain and its hard.
Im just telling you my story in hopes to help you. I also do acupressure as your muscles can be locked up in your back and that hurts like hell. look for alternative medicines as these pharmacuticlals are all bad. I deal with depression everyday but not going to let it beat me. Your mind is the Key as the drug takes it prisoner and puts you/me in a HELL and we do not deserve that as the pain alone is Hell. whenever someone says to me the pain can’t be that bad I tell them they should smash there toe or finger everyday for just a year. They look at me funny and I say thats what it is like. they dont say a word after.
I wish you the best but if you dont taper down not only will you be in pain but your internal organs will begin to fail and that is worse then pain.
God bless and I hope this helps. Im not perfect or know all the answers but what to give my story and hope it helps just one person.

Opioids do not damage internal organs, but non opioids do. Good for you that you have no pain. I did everything the pain clinic asked me to do but I was still not functional. I found another pain clinic. I take 180 morphine equivelants and am not out of pain but I am functional. I am able to get through my day and enjoy life. Pain patients should not have to suffer because of the addicts. When you truly have pain you don’t get ugh from these meds. I think it is shameful the way we are being treated. We have not been included in the conversation about opioids. Lawmakers only care about addicts and think we all are addicts.

I would think you’d be a little empathetic towards addicts.
Have you thought that psychological trauma/psychiatric conditions can cause people to get relief anyway they can. And if you think the politicians and lawmakers give a damn about us, whatever…

I hear u exactly. Lied to get in methadone n stayed in for 7 years. Got tired of the lieing. Then soebr 5 years in agony. Spent the last year where a pain Dr prescribed suboxone- but 3 mg daily when recommend dose is 8-16. In cibstanr withdrawal. I am going on wed to the methadone clinic- im buying some drugs so I will be dirty. Then I’ll have to go everyday n to group n individual counseling- it is all such a joke. If u ever want to talk hit me up- hey the methadone kills allll the pain

U sound just like me all but I’m on the methadone an there taking me off my dr had to close an he sent me to this dr an he’s taking me of of methadone fast an nothing else I was great till I went to the new dr my pain was better I feel for u nobody wonts or can I don’t no I may have to go to a client to but that ant right having to get up ever day I’m so sorry for u I no how u feeling u here of any thing please let me no I’m in Alabama

Why is my comment hidden people? WTH? People of this world EVERYDAY are apathetic liars and hateful people who look at peopl in pain like they are scum but the HATING LYING GREEDY people of this world are the true SCUM while they hide behind their wealth and greed and things and keep hating and making it hard for people who are telling the truth!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I just had the same experience as you, tried posting a perfectly grammatically and scientifically correct experience (not to mention my 10-year battle with addiction, recovery, replacement medications, and my 2-year successful recovery period). They both didn’t show and gave no offer of explanation or even an error message. I just wanted to ask someone (who had posted to ask him if they needed help with switching to Methadone….) if they had any info at all that could help me. Maybe it’s because the opioid I’ve been so hopelessly chained to for nearly 2 years isn’t sold in a pharmacy? Not like I was trying to claim accurate, ergo, ANY conversion ratio between the two. Very disheartening to people who come here during a period of hope to enhance their lives and get shut down with no explanation. Great job.

It’s called discrimination and it is everywhere I was an addict for 10 years using pills and heroin then I go and try to get help and I find that the methadone treatment program is the best option for me if I go out and try to find a job the employer’s will discriminate and a criminal background no felonies but several misdemeanors I have actually done this and I am having a very hard time trying to find a decent job I’m not talking about McDonald’s or Walmart but like a career I go to a treatment program where I live only about half the people there have jobs and that’s because they had gotten their job before they got on the program it is downright ignorant for people to discriminate when you are trying to get help for yourself that’s all I’m saying…

As an employer, I can tell you that hiring addicts is risky. There is a chance of relapse, not showing for work, stealing, etc… There is no justification for committing crimes. Just because you are addicted to drugs doesn’t mean you have to live like a scumbag. I’ve had plenty of issues with addiction myself, but still tried to live my life like an upstanding member of society. People need to take responsibility for their actions, whether they were messed up on drugs or not during the offense doesn’t matter. Keep working on your life, and if you have to go work at McDonalds for a few years so be it. You got to start somewhere.

James Bowser, I agree with you. Any thing John did in life was of his choice. He blame his problems on society. I didn’t tell Dr. Fudin the length of time on methadone. I want to say, if you want off, then tell your Dr. If he won’t help, keep trying Believe me, I was surprised that 60 mg to 30 mg was tolerable You think not, but try it after talking to your Dr. and ask to get his opinion It feels good, John, to finally have a clear mind. It’s uncomfortable, but with God’s help, your desire to be free, everyone can get off. I’m 3 months short of 70 years old, so there’s no wrong time, but start soon. Life is short and we must stop making excuses.

I’m positive that it’s litteraly easier to find a needle in an kilometres bale of hay. Than to find a Dr., who is truly empathic, and educated enough to tteat those of us who are in real pain. Most of them base a lot of diagnosis by reading thimgs others posted. I personally have had a combination of injuries and illnesses that make extremely difficult to for myself what the origin is.

Toxic; I cannot allow a post giving medical advice. The conversions and information you provided were inaccurate. Equally important is that methadone metabolism is very patient specific so even if there were a universally acceptable conversion ratio, the half-life varies from 15 hours to 60 hours, up to 150 hours in genetic outliers. And, that doesn’t account for the countless drug interactions because of the way it’s metabized.

I have a question that has worried me for some time now..the doctors in TN. Know NOTHING about methadone…I had a spinal cord stimulator put in, last June. I was told that the methadone will be fine to stay on during surgery, and added pain meds will achieve the pain relief i need. They were WRONG!! I laid in the hospital 3 days and nights SCREAMING IN SEVERE PAIN! I am on 120mg…and I’ve had 4 back surgeries, and have significant pain…my question is, should i have stopped the methadone until I got past the “painful period” after the surgery? I feel like the methadone blocked the othere med..they gave me. Morphine, I suppose, in I.v…..and on the second day, they gave hydrocodone every 4 hours…which is like candy to me…I have a BIG SCARY fusion coming up on L3,4,and5 soon….should i DISCONTINUE methadone for a few weeks after surgery to be on normal opiods???? I’m so worried…I don’t wanna be touched, but my pain and weakness is horrid

I had 6 titanium brackets put on my spine “L1-5 and what the doctors did not tell me since I was on methadone that I also would wake up and recovery and feel everything with no pain relief and I also have to undergo a double mastectomy and I rather die while being on methadone I have been titrating down now for one year and I’m only at 51 mg and no rehab will take me and they damn sure don’t accept state insurance so I’d have to pay upfront close to 20 grand to try to get methadone out of my system but the doctor got his $250,000 for doing my surgery didn’t care about the pain I suffered I woke up in recovery screaming I pulled every tube out of me even the sewn in drain tube out of my neck and I walked out of the hospital out of my recovery room!!! Only thing

It didnt block anything. There is no naloxne in methadone so you can take other pain meds on top of your methadone dose but there is increased risk of side effects and respiratory depression. Speak to your doctor. Get well

I have a question that has worried me for some time now..the doctors in TN. Know NOTHING about methadone…I had a spinal cord stimulator put in, last June. I was told that the methadone will be fine to stay on during surgery, and added pain meds will achieve the pain relief i need. They were WRONG!! I laid in the hospital 3 days and nights SCREAMING IN SEVERE PAIN! I am on 120mg…and I’ve had 4 back surgeries, and have significant pain…my question is, should i have stopped the methadone until I got past the “painful period” after the surgery? I feel like the methadone blocked the othere med..they gave me. Morphine, I suppose, in I.v…..and on the second day, they gave hydrocodone every 4 hours…which is like candy to me…I have a BIG SCARY fusion coming up on L3,4,and5 soon….should i DISCONTINUE methadone for a few weeks after surgery to be on normal opiods???? I’m so worried…I don’t wanna be touched, but my pain and weakness is horrid

Methadone does not block other opiods??? Sir i have been attending the clinic since 2005. I am a counselor as well as an experienced dryg addict. I snorted 6 oxy 40,s while on 130mg of methadone and felt nothing.

I have been working in health care for over 25 years. I have a masters in nursing and continued on to become a NP and the information that I’ve always been told is that methadone does block other opioids. I would not take anyone’s advice on a site online. Schedule an appointment with a doctor that works in a methadone clinic and he will give you free advice and at least he will be upfront and honest with you. Please don’t just take anyone’s word. After talking to a methadone doctor then talk with your doctor and if he isn’t willing to make you a promise to keep you out of chronic pain then please find another doctor. Some doctors assume that 120mg is just a extremely high dose of methadone and it is but if you have been on that amount for years then most likely you would definitely need something more for the pain. I am in no way telling anyone to take my word I’m just hoping to give enough information for you to be able to find the correct answers for yourself by going to other doctors. You can go talk to a doctor in a methadone clinic for free and they will be very upfront and honest with you. Don’t settle for one or two opinions get several different opinions from different doctors that deal with methadone and that doesn’t deal with methadone. Just remember every case is different and no one deserves to have to deal with excruciating pain after major surgeries. Good luck to you all and remember it never hurts to get several different opinions. Good luck everyone. And please understand I’m not giving you advice about medication I’m giving you advice about getting different opinions from different doctors that deal with methadone and doctors that don’t deal with methadone. Good luck

It Matters not how many masters degrees you have.Many Methadone Maintenance patients that I have Known Personally simply take methadone and then go get destroyed on Heroin or Morphine tablets. It is a poorly kept secret that an addicts get blasted on all manners of opiates while on a dose as 120 on methadone. It is a fact of life in the recovery community.

Im taking 72 mg of hydromorphone contin per day and want to switch to methadone at a clinic. How much methadone will they prescribe to replace what im taking in hydromorphone contin. Ive red alot on internet and just want to make sure they dont give me too much
Thx
Ken

ive been on methadone for 8 yrs on various doses and come off of,it twice as well. methadone does not block other opiates. it increases your tolerance to the point it would take a very high level of other opiates to get high or feel relief. i know. ive done my own “personal expirimentations” on this earlier in my treatment.

Suffering addicts who come here to find information on does conversion during possibly their ONLY, brief period eof hope and a light at the end should at least see a comment posted here that tells you what you are allowered to say or not. I was incredibly disheartened when I tried to post 2 personal, scientifically and gramatically correct (without suggesting drug interactions etc. would not influence a major decision like methadone) and greeted with no message explaining why it had not been posted.

Andrew, As mentioned in a previous comment, I cannot allow people to give medical advice or opioid conversion advice on this forum. A more comprehensive answer as to why you didn’t see an explanation is at https://paindr.com/blog/about/

Jeffrey, You say there are “countless” drugs that interact with methadone. Would you please list the drugs that reduce the effects of your methadone dose. I am especially interested in the interactions between nicotine and methadone. Please explain the pharmacodynamics of these two drugs as to if and how nicotine can reduce the effects of your methadone dose.

I am writing this on behalf of my mate as he cannot use his phone,he has been prescribed methadone now for over a year,he was getting 60ml daily but due to a mix up with the doctor his prescription was not wrote out correctly and he missed the three day window,he was given an appointment to C the doctor and theye only gave him 20ml for two days and 30ml until he sees the doctor again,is this legaly moral and correct use of his powerstuff to prescribe as my mate is suffering and had to use opiates to overcome the massive drop in dose. Thanks for taken the time to read this.

Chronic pain patients should be in a separate category for prescribed opiates. One’s ability to lessen pain, or better yet, controlling pain, should not be taken away! Reduction of prescribed amounts is only thee first step in taking all opiates away. I’ve yet to hear what their idea is as an alternative plan for people in chronic pain? Is our quality of life only of value to ourselves & those who love us?! It’s become clear, it is, we are, NOT important to “the powers that be?!” What is our alternative choice? This isn’t an alternative but it may be helpful. A drug called: Cymbalta, marketed to people who’ve become depressed with chronic pain. (There are generic brands available now too. I was originally prescribed it when there wasn’t.) It’s basically an anti-depressant that also helps with some pain relief.
It’s too bad all thee chronic pain sufferers couldn’t come together, make a stand, & to be heard, it might make a difference!!?! I know if I didn’t have a Son, it’d be just too much! Hanging around here, every single day & night in pain…that’s not a life of quality, The knowing that tomorrow won’t be better, that today & all your tomorrow’s will be debilitated with pain…unbearable! I hope & pray we’re not left with only the raw nerve endings of our all encompassing pain! For me, losing my only sibling (a Brother 3 years my senior) to ALS & both Parents to cancer with-in 17 months of each other, (just 7 months ago),certainly doesn’t help. Denied any type of anxiety medicine because ” I take opiates” accumulated into a nervous breakdown. We must all find courage to have Hope for the Future! (And see about getting a Rx for generic Cymbalta!) I hope my post helps with relatability & a new idea to battle “being bummed out, that you’re stuck with chronic pain” prescription,

I was on methadone, hydos, and clonazepam for over 16 years and had them just taken away from me and was placed on Suboxone. I am one of the few that suboxone and buprenorphine tablets just didn’t help and made me feel so damn sick all the time. This occurred in March of 2017 and just June 1st, 2018 I was changed back to methadone — to 5 mg once per day. I was on 40 mg of methadone. Obviously 5 mg is not enough as for some reason I feel as though I am in withdrawal – I could tolerate about 1 mg of Buprenorphine a day and that’s it…would the buprenorphine still be blocking the effects? From my research I don’t think it should be.
I feel like being taken off of all these drugs at once has given me permanent brain injury — very serious here – as I literally cannot wake the hell up mentally – I forget everthing and anything. This has been a nightmare. I know that Benzo’s can cause this, but I was on the Benzo for all these years and now they suddenly are taking them away from pain patients and are causing severe long term cognitive decline and brain injuries. I know from using a benzo with my methadone that I was never in any danger of respiratory of heart failure — they have to look at Quality of Life instead of Longevity. Screw longevity when the quality of my life is this low I have no desire to live long – in fact I joke and say it is my curse to live long.
I just feel for the Pain Patients who are totally being ignored — I cannot even write a coherrent paragraph here, but I am suffering big time right now and the major problem besides pain has been complete Lack of Motivation and not being able to think – it appears I just can’t Wake Up. Does anyone else understand? I know I am likely a very rare case. Thanks

Abrupt withdrawal from meds like Ativan ie: benzodiazepines can cause permanent psychosis according to PDR. You obviouslly were spared that but the physician who committed such an awful action & risked such an outcome needs education and review from his licensing Board..please report him or her to AMA & his particular Board for his pain mgmt specialty I’ve always been too scared to do anything against the physicians who have harmed me but we have to fight back.We should get a patient advocate to help get the care needed . Try your local large hospitals for in or outpatient programs. Supposedly they help us with all care when suffering severe chronic illnesses that cause pain and exhaustion. Heh… my area programs turned me away but you may have better luck…do zipcode search… Nonprofit site- getpalliativecarenow.org .It is so evil, to pretend to be caring professionals who seem to hate those of us who require opiates to survive incurable, unendurable pains despite exhausting other options. I think the gov’t is trying to eliminate us pretending to stop deaths by overdose. Suicide rates have increased 29% since they’ve been witch hunting good pain doctors & restricting chronic pain care.

I just want to connect with someone. This is the first place I have ever found people with similar experiences to mine. I’ve had chronic pain since I was 32 I m 47 now- and feel old before my time. Brief history- was on large amounts of narcotics- fentanyl oxoycitton with some psin relief. My Dr got into trouble prescribing pain killers so I went into refill n she just told me we should wait n see how I was without the pain killers. I started crying- knowing how much withdrawal n pain would hit me but she wouldn’t change her mind. I had never failed a drug test. After the worse week of my life a friend let me have 30mg of his methadone. Couldn’t find a Dr to prescribe for pain so o learned what I had to say to get into a drug program. It worked but at 130mg i had tons of side effects n didn’t know that reducing would make it better. Plus after 7 years I was tired of “being a drug addict”. I went off- a mg each week n hot off with no withdrawal (of anyone wants info about that let me know). Then I spent 5 years wuth only lyrica n cymbalta for pain relief. It would hardly be fair to say I was living. I couldn’t go to the grocery store much less lead a life. I found a pain Dr willing to help- He put me on suboxone- 2 to 3 mg a day. Unfortunately I went through withdrawal continuously. So here I am about to enter a methadone program- again as a drug addict. Sometimes I can’t find a reason to keep trying. I have no quality of life right now. My email is amys3269@gmail..com. Would love any advice or even to talk. Hope u all find some relief- take care

I don’t understand why you can’t voice ones opinion or fact to ones experience in methadone. If you are not being treated fairly or right, voices should be heard and comments should be made. Others needs your help to feel or believe they are not alone in this cycle or battle of addiction. I myself wants to be weined off.

Can someone experienced please help me? I’m on 75 mg of methadone. I was on 150 but tapered down and have been on 75mg for about 8 months. I want to get off & I went too fast & tried going from 75-65 in 1 week and for some reason I threw myself into withdrawl &had to go up from 65-75mg so have been afraid to decrease anymore after that happened. I’ve been clean since 2/9/16 started methadone 2/2/16. I want move to mexico and there is no methadone there so would like to come completely off. I’m so weak when it comes to withdrawals &handle them terribly. A Lil sweating will over the edge. What is the quickest smoothest way to come off with as lil withdrawal as possible? My email is senecalazaro@gmail.com
Thanks so much

Hey Seneca,
I was on 55mg for two years and started tapering not long ago. I was able to taper down 1 mg per week down to 23 with absolutely no withdrawls or discomfort. Everyone’s body reacts differently so I would just make sure you’re consistently talking to your doctor about any negative symptoms and don’t be afraid to put the taper on hold until your body adjusts. Just go slow and steady.
Now that I’m at 22 I’ve slowed it down to 1 mg decrease every other week or so depending on how Im feeling.

Trust me, if you find a taper rate that’s right for your body you shouldn’t be feeling any discomfort. I’ve been able to continue working and going to school all through mine.

Good Luck with your taper and move to Mexico, im trying to get clean so I can move down to Costa Rica myself 🙂
You got this

my name is Danny I have been on oxycodone 30 mg an oxycontin 80 mg for 15 years from the same doctor do to my chronic pain my main question here is I do not be need to be weaned off of medication I need my medication for my pain my main question is if I take 40 or 45 oxycodone 30 mg at once will it in this pain and suffering I’m going through that’s my option right now and I plan on doing so but I don’t want to do it if it’s not going to work I want to end my life at this point as soon as possible thank you and God bless see you on this side of the other or the other

Awe,please don’t say that but I understand your pain. I had a back spinal fusion and I am crippled now. Barely can walk for 5 minutes now when before the surgery the pain was there but Nothing like THIS PAIN I feel every damn moment of my days,I wouldn’t be here if it wasn’t for my daughter…but please hang in there,it Will get better. My family has had several suicides and it just hurts everyone! Xoxo

I hope you do not consider doing this, let me just say that opioid medications do complicate your emotions and what you are feeling may not really be you…it may be the result of years of medication suppressing your endorphin system causing a depression. As time goes on while using these types of medications it suppresses your natural ability to be genuinely happy thus causing adverse thought or action. I would definitely talk to your doctor about what your going through, and maybe a family member or friend. Its not worth doing what your thinking of. I would hate to hear this happen. Everybody deserves to live, and happily. My thoughts and prayers go out to you. God Bless.

Hi Danny,
I hope you didn’t en your life! I know how it feels to b in pain every day all day that you can barley move or want to get out of bed. I was taking pain pills for the last 15 years for lupus and Crohn’s disease , I was on Fentanyl patches 200 mcgs and oxycodone 80mg 4x a day and I just got off of all of it little over 30 days ago and my doctor now has me on methadone and right now I’m at 110mg and I still have pain but it’s so much better than it was when I was on the pills and patch. I go up ever couple days by 10mg . There’s such a stereotype when people talk about methadone they think of attics and so it took me a long time to accept that my doctor wanted to put me on it for chronic pain and I’m telling you it was the best decision I’ve ever made in my life. Please talk to your doctor first before you think about taking your life I had those thoughts at one point too and I was open with my doctor and he thought methadone would be the best thing for me and it has been. I know taking your life seems like the best decision to make but it’s not talk to your doctor you can be almost pain-free with methadone and you can start living your life again I have and I didn’t get out of bed for months at a time so please talk to you Doctor.

Hi I’m at a clinic for about 6 months now, been on 120mgs for a while now. I can’t afford to go anymore so they have to be dropped 10mg every day…… So in 12 days im done. Been on it before I wrnt there to for a few years. I’ve never dropped that fast and I’m scared what I’m going to go through. Can anyone give me any tips or help please, thank you .

Hi I’ve been trying desperately to find a methadone mg to morphine mme. I’m afraid my husband is going to die. The charts don’t make sense. Some charts say 90mme is equal to 20mg others said it’s 5 mg equal 90mme. There must be an estimate. Thank you

I’m going thru the same thing,switching from methadone to an opiate and the charts are all different, it’s ridiculous bc I’m dying in pain and it’s been 3 long years. The fact is there isn’t much data on it and what there is varies so widely for Tons of variables. I’m so sorry that your both going thru this,I wish you hope!

I know there is a lot of negative clout about methadone but it saved me, I was at 180-300 mg oxy and I couldn’t taper myself no matter how much I tried. So I went to a clinic where they switched me to methadone, no withdrawal, then I have been tapering 2mg a week so I don’t experience any withdrawal. But stay on a low dose because it can cause weight gain, blood sugar problems as well as high blood pressure..

Take it one day at a time. get a solid support team, especially whenever you go haywire and really need someone there. To coach you or hug you. If you can get a couple of different levels of the same pill this could help alot . If you find you not understanding how. To do the doses in smaller, it is no shame asking a doctor for help i have never heard of one tossing out for asking for help to come of pain meds , unless you were filed a restraining order that stay away. sometimes you find a nice doctor that will help you come down off the medications over a couple months. This isn’t likely the case in most situations. These are my suggestions:
Week 1: 4 each day as you have been taking normally.
Week 2: Lower to 3 each day it is your exactly when and how much but only 3 a day.
Week 3: Lower to 2 each day and like week 2 all of the when and how is your decision.
Week 4 and on: here on you might have different dosage of different kinds of pain medicine to also help you come down. If not then just keep taking 1 a of day until you’re fully out or until you’re just saying why am I taking us finally and throw it away down the toilet you are stronger than anything else you will survive this over anybody. Put in your head and u tell your heart and sometimes you have to keep repeating it that you are stronger and you can and will do this! Just telling yourself this can be the biggest battle!
Any advice taken I am not liable for I do so without vicious will, i do this bc so many wanted knowledge.

So what’s your “easy off”? I’d love to know. I take methadone with Norco as back up, buy my state has decided that my pain management doctor can’t give me this combo anymore. It’s been 2 weeks and instill feel like I’m going through withdrawals. My joints each any help would be appreciated!
Thanks, SamiBrownbottleoils@gmail.com

Hi Greg,
Could you please provide me with your email address? I took 120mg’s of methadone per day for two years for severe chronic pain, and I began having so many side effects and/or other health problems (however it worked better than any other opiate for relief of my chronic pain).
I weaned myself off of it a year ago, lasted about three months, but I still had all the same negative effects.
I’ve been taking only about 10-15mgs per day over the last year, plus a load of dilaudid, and I’m still stuck with the side effects I developed over the first couple of years from the high dose of methadone.

My doctor is baffled about it, says he’s never seen anyone as bad as me. He is licensed to prescribe, although he has very few patients on Methadone

Please email me the easy off info you know of. I just got started on methadone and im prepared to be on it no more than a year because i want to be free from drugs! Obviously im afraid of being sick but i realize i will probably be a little uncomfortable unless you know of a miracle remedy for weaning off.please help me.Thankyou! Shawnahz@gmail.com

I’m getting clean from heroin I am on 45 mg of methadone A-day when will I be able to go down and is 45 mg a high dose? It keeps the withdrawals completely gone and to be honest I don’t think I need to be this high of mg. Help I just want to be clean and free of it all

Hi, I’m trying to help my husband. I’m worried about him. He has been on methadone for 3 years 80mg. He decided 3 days ago he was done, just done. I’m really proud of him but I’ve heard terrible things about coming off cold turkey. But many things on the internet are conflicting. Can you email me and help me so I can help him. I would really appreciate it. Alyser87@gmail.com

I’ve been in chronic pain since August of 1996. Looking for the best methadone to MME equivalent IS frustrating. It’s the “half-life” of it in your system that’s complicated & confused any sort of accurate conversion for MG’s to MME’s. Regardless, my half-life is residue of the drug in our bodies, not pain relieving amounts. (Like THC in your blood/urine long after consumption.)The benefit of pain reduction from Rx only lasts about 4 hrs. My dosage went from alotted 20mg 3xday to 10mg 3xday. Yesterday my Rx was written for 10mg for entire day!!?! Debilitating pain day in day out isn’t (can’t be?) understood by people that haven’t experienced it! Our pain relief is being controlled by the gov’t. Worse, they’re not Doctor’s or even Insurance adjusters that (*key) don’t bother to look into our medical history’s. Everyone is lumped together into the same category, opioid users. It’s become obvious their end game is total elimination of opioid use!!? With chronic pain knowledge of; tomorrow won’t be better, How can it be a good idea to take pain relief away?!
I’d like to know what you did to no longer take methadone & have any sort of quality of life?!

My Dr wants to switch me to methadone because insurance will not pay for the OxyContin I have been taking. I take 60 mg of OxyContin three times a day. I take it for my back. He says insurance will pay for methadone but not OxyContin. Thank you in advance for your time

Can you please send me your contact info? My fiance are both tapering down from methadone and are reaching a point where the detox symptoms are causing us to slow our pace. We would like to continue at the same pace if we can find a way to manage our symptoms. My email is flo48066@gmail.com.

I have chronic pancreatitis and have had it since right after the birth of our 3rd daughter. I have tried so many different pain meds but nothing works like methadone. I am now finding that doctors are cutting my dose for no reason at all and I am having the hardest time. All I want is to go to the grocery store without crying at home for hours after because I hurt so bad. I just feel like giving up!! I have 4 teen daughters and they still need me to be their mom!!! I feel helpless!!!! Is 90mg a day insane I have been on it for 8+ years?

Hun 90mg isn’t definite not an insane dose people are on as high as in the 1 and 2 hundreds for pain. Not talking about methadone clinics where addicts unfortunately need high doses i.e 100mg and above and it’s like taking a tylenol to them. Any way there is a lot of wiggle room for dose adjustments for the meth but tell your pain dr. Exactly how u feel on the 90mg dose which I assume is 30mg 3×daily…. if u want to talk more email me at brescia0124@gmail.com

Agreed, im on 150 a
Day, was 200mg at one point. Pick up once
A week and away we go! Some elple meed more, some less. These amounts are not reserved for hospice settings. I work full time 10 hours a day 5 days a week. If the methadone hit me that hard, I wouldn’t be able to sit at my desk and type all day.

I have an inoperable vertebrae collapse condition since 1993. I was born with my spine only partially connected at bottom. When I move, my spine moves and this causes severe sciatica. A neurosurgeon diagnosed me via a cervical kilogram test after many other doctors could not diagnose me from 1993 until neurosurgeon found my problem in 1997. He said surgery was not an option and said to find pain management with pain medications. I went to a pain clinic in 1998 and was put on 120 mgs of methadone per day. Took it for 14 years plus morphine prn for breakthrough pain. The idea was to keep on top of the pain. Still I had severe sciatica and it would wake me up and last all day until I finally passed out from exhaustion due to crawling around on the floor, pounding parts of my body that didn’t hurt to detract from the pain. It was like toothache pain the worst pain and constant. Once it came, nothing I did it took helped. I could not stay still yet moving around didn’t help either. Luckily, I would only get it for a day at a time and I had bouts of it approximately 5 days per month. Once I slept I would wake next day and sciatica was gone but my body was sore for 2 to 3 days. Then I would be so worried about when it would come again. It was no way to live, but the methadone did help me not get sciatica as often as I had it prior to being diagnosed. From 1993 (onset) until I was diagnosed on 1998, I was told I just wanted narcotics and it was imagined all in my head. I never liked drugs that clouded my mind and prior to this problem, I was athletic and I got my highs from running. In 1981, I ran the mission bay marathon in San Diego after training for it for three years. I was the 22nd woman to finish the 26 mile run out if approximately 1000 women and I felt the best ever then through exercise, both physically and mentally. I had no idea I would have this horrible thing happen to me, but in 1993 after moving to northern Michigan, I began to have pain deep in my lower spine and buttox that was hard to explain and I had just found a job in my field (hard to find in a small town) and then onset of collapse of spine began. It took 4 years of tests and not being believed until I was referred to a doctor who found my problem. He said surgery would never be an option. So I took methadone after trying many other meds that did not help at all. I did feel 130 mgs was excessive but I did what I was directed to do by pain specialist. After 14 years I heard of another specialist and after consulting with him I left first clinic and began going to this other doctor as he felt I would do just as well with 90 mgs and he had other suggestions like good shoes, Pilates ball and a wonderful back brace. He helped me to wean to 90 mgs and I had a great 2-1/2 years with only rare bouts of severe pain with this Dr. Unfortunately, he closed his clinic in Jan. 2014. Then my primary care physician had to take over prescribing my methadone, a med she did not normally write for. She got me down to 70 mgs in about 18 months. Then, all Hell broke loose here in Michigan and all doctors are scared to write for pain meds. I kept weaning and got to 40 mgs a.day, which was really just as effective as 130 mgs I started with in 1998. I always have low back pain, but have learned to cope with it even at 40 mgs a day. Then I was told I could not get the methadone and in Jan of 2018, not only was I abruptly cutoff but am now treated as a drug addict and my sciatica plus nerve pain has returned but I can not find any help and have looked all over the state. I am 67 years old and now someone else gets to decide I can live with the pain. Too bad for me. Doctors are afraid to give any narcotics at all. In April of 2017, I went to see neurosurgeon who diagnosed me with a fresh MRI in hand. He said no way could I survive a surgery that, at best, would only relieve 20% of my pain and 4 months of what he said would be horrific pain, post op, would not be something I could get through. He said I would need rods, screws, and cages and my body would most likely reject the steel so he said surgery would never happen for me. Too risky and I believe him. So here I am still looking for someone to prescribed methadone. Even 20 mgs a day would be fine. I have tried shots, many other meds, physical therapy, acupuncture, and nothing works like the methadone. It just seemed to be the best med and I did not get a high from it. I am worried what I may do now that I can’t find it, even at a low dose. I never misused it or abused it and can not understand why I can’t have it. I do not ever drink alcohol or street drugs so what is the risk. If doctors had been more proactive with those they gave methadone to, kids and others would not have abused this med by mixing it with bensos and alcohol and would not have died as a result. By proactive I mean counting pills and urine tests every 28 days or more. I would insist on a doctor testing me and counting my pills and even calling me in before scheduled appointments to make sure I am adhering to the rules. Instead I fell between the cracks and my life is going downhill. I still have bad withdrawal symptoms even though I have not had methadone since January 2018. I feel I will never get back to who I was before I took methadone and I am angry that I worked 34 years only to retire into a life of Hell. I am considering ending my life at this point because of how I feel, the pain, and being treated like a drug addict. Let me finish by saying I have other medical problems like ADHD, PTSD, ANXIETY NOS and OCD. Now I have agoraphobia and just sit here alone and pray to not wake up tomorrow. Why did this happen when I was willing to wean down? I would love any advice you may have. I took too much for too long to get over it. I want this drug only because it was what helped me and I have tried too many others to mention. Now I can’t even enjoy my retirement. My family are all dead. My marriage died in 2015. Yes, I see no reason to be here anymore except I have two cats whom I love and do not want to leave. I needed to return to work as I owe 50 thousand dollars on the home we bought in 1997. I can not work if I can’t count on when I will or will not wake up with sciatica. I kayak and bike ride for exercise occasionally, but could not run once around my house now. Maybe all that running was not such a good idea as I am filled with arthritis, fall down a lot and just hide in my house afraid to even go for groceries. Since no methadone, I have gone from 135 to 104 pounds. That would be good but I lost weight because I do not care to fix food anymore. I think the doctor who gave me 130 mgs a day of methadone, should have his license taken away because I now know 40 mgs would have been just as effective for me. That is my story and may not have been the same for others, but using it for so long and being abruptly stopping was a bad thing to do to me and no one in medical profession seems to care. Any thoughts or advice would be appreciated here or to my email. jalonms1950@gmail.com
Thanks for reading my words.

Hello I’m so sorry about what you’re going through I know the feeling all too well. Is there not a methadone clinic in your town or nearby city that you can go to right now the law just passed and all methadone clinics are free and state-funded. I would try that and hopefully you will get some results. my prayers and thoughts are with you!

My comment to another person applies to you, too so since it is still here,
So many of us are going though this Hell as govt via Fascist dictates have scared good pain physicians into doing harm by weaning or discontinuing life saving opiates….but we have to fight back.We should get a patient advocate to help get the care needed . Try your local large hospitals for in or outpatient programs. Supposedly they help us with all care when suffering severe chronic illnesses that cause pain and exhaustion. Heh… my area programs turned me away but you may have better luck…do zipcode search… Nonprofit site- getpalliativecarenow.org .It is so evil, to pretend to be caring professionals who seem to hate those of us who require opiates to survive incurable, unendurable pains despite exhausting other options. I think the gov’t is trying to eliminate us pretending to stop deaths by overdose. Suicide rates have increased 29% since they’ve been witch hunting good pain doctors & restricting chronic pain care.
Do get helo if truly suicidal but if you mention that or ANY past or current anxiety, abuse, depression or also any problems with falling …. they will use it against you to deny pain meds. Especially if sent to psychologist for testing…. they are not on your side. Get help seperately without any chance of it getting back to pain clinic. This is a crazy, evil time when pain patients are seen as weak, crazy, junkie, useless, time/money wasters by most doctors & govt is pushing regulations to push us over the edge. Fight.

Hi,
Doctors are now cutting doses because of the new federal
Limits that state patients can only be on 90mg of morphine or it’s equivalents. I’m not allowed to say what those equivalents are but ask your doctor and he will tell you as it ranges and there is no definite number with regards to methadone. But in my state the max amount of methadone a pain patient can receive is 30mg in one day. Actually the max is 25mg but if a doctor feels the patient needs 5mg more he can write a letter justifying it. If doctors prescribe more than this they can lose their license which is why doctors are lowering doses like crazy and in some cases, not prescribing certain opiates. I talked to my pain doctor in depth about this. His hands are literally tied and he cannot raise the dose anymore. If you want more info look up the new federal limits with regards to opiates. This is all due to the opiate crisis and politicians trying to make a “change” so these new limits have all been imposed. I’m not sure how many states it has affected yet but soon it will affect them all so if you are on a high dose of opiates don’t be surprised if your doctor starts lowering it. It’s terrible that they are penalizing pain patients. Meanwhile if you go to a methadone clinic, which is supposed to be for addiction, there is absolutely no limit on how much you can be on. I know someone who is on 300mg which is crazy, meanwhile we are limited to 30mg?! They say that pain patients are the ones selling their meds which is why this new limit is being imposed but I know people on the clinic who sell their take homes so it really is ridiculous.

By now you should be feeling the full effects of that fast of a drop, it takes about 1 month, you will have intense back pain and lethargy, your temperatures will rise and fall, and you might even get the typical wd stomach pains but it lasts forever!! Don’t drop that fast, spend the money on going every 3 days if you have to or even every week just to keep it in your system for at least another month to stabilize:

Dear trouble girl,
Unfortunately ,i am a walking dictionary of information and my information is good and accurate in my opinion better than anyone i know. You’re right and some of these people here [i would like to say something else] should keep their mouth closed.

I had to do the same. 120mg to 0 in 18 days. My withdrawals were so bad that I went on suboxone 8mg and weaned down to 1mg over two months and now two weeks off the subs and still feel like crap. However, staying busy, walking, kratom and a natural sleep aid is helping. I hope you are hanging in there! We can do it!

Everyone is different. Everyone handles and feels pain differently. Due to chronic pain, I have tried a lot of meds, at one point I was taking 3 Lortab and 1 10mg methadone….dropped all other meds and took 40mg of methadone a day in two does. It worked so well I had banner years with my business. Methadone is also cheap. The so-called opioid crisis is NOT due to real patients taking pain meds to have some sort of quality of life. I strongly suggest anyone who has trouble with addiction and does not need so many mg of anything and is simply strung out by their own doing should simply go to a methadone clinic where the pros are who know what they are doing. I changed every doctor who wanted to prescribe MS Contin…Morphine and would not give me methadone I simply acted as professional as the doctor did and continue to seek what worked. BTW I do not know how to buy drugs on the street. In the last 20 years that I have been on pain meds, I got married raised two children sent them to college bought a home, some Harleys, started a business and so on, I am still married…my kids are doing well.

For me methadone did it well and I would have never lasted on anything else. One thing methadone does that most doctors don’t like is methadone raises your blood pressure. So, remember this different for everyone….things are changing for me due to I was born with heart disease (murmur) now I need two valves fixed…the first thing that happened is I was discharged from my pain clinic for using CBD oil…the clinic cleared house after it was sold to a huge company…so its clear that clinic did not have my health in mind at all.
I needed a pain doctor….I will have open heart surgery to correct my valves…since the first doc I saw at the clinic I was going to was so good to me in 2013 I found him again and wemt to see him…..he was the one to start me on methadone…since he can no longer prescribe methadone in the state of VA where his new office is I live in MD….now the bad part for some reason he thought 10mg of oxycodone will keep the withdrawal away and help my pain…I waws on 40mg of methadone a day with 20mg of oxycodone a day…he wrote me up for 4 10mg oxycondone a day…OK that worked for the first 12 hours….OK I found another went there was treated so well…..they put me on th eOpana 15s X 2 aday and 4 15mg oxycodones a day…OK this worked…no withdrawal and pain levels back down…work back up life is good again now for the surgery in two weeks.

Thank you for sharing your story. I have been on methadone for a couple years and it is the only thing that helped me with pain and it is very consistent. Not sure what I am going to do now bc my Dr. said New York State is changing the law here starting 1-1-19 and will only allow a maximum of 90 mg of per day of morphine equivalent. I am taking a total of 50g of metheone per day now and don’t know what that equals in morphine. I am also going to get my medical Mary Jane card next month. I hope it will help so I can reduce my pain meds.

As a chronic pain patient for 20yrs and as someone that worked in health care until last year I feel maybe I need to say this. I want to preface this by saying I don’t think this is fair and god knows I have went through my own hell. You have been very, very lucky up to this point going from one doctor to another and another. I’m guessing you crossed state lines somewhere. Unfortunately this is considered “Drug Seeking” behavior. Yes I know you are looking for a doctor that will keep you on what works, but you can thank the drug abusers for this and it’s been this way for many years. I would love to seek out another pain doctor, but I don’t dare do that. You can’t even mention what medication has worked for you. If you go to a new doctor and say pain drug “b” works best this is another drug seeking behavior. Those that actually abuse drugs do this wherever they go. They will be “allergic” to every drug, but the one they want. It’s not fair, but life is not fair. If a doctor, which probably won’t happen today asks you specifically what has worked in the past then its fine to mention drug “b”. It has always been this way, but with this daily attack on opiod addiction the doctors are feeling the pressure. Most chronic pain patients never abuse meds something like fewer than 5%. You and I should be able to go to another doctor when your doctor only uses one medication, or in my case treats all patients with the same drug and actually does no pain management. Oh and by the way. All of this opiod abuse is NOT prescription meds. It is Heroin and fentanyl. The 600% surge in overdoses was caused when all the family doctors sent their chronic pain patients to pain specialist and they quit writing loratab and percocet to everyone that said they hurt. This ultimately dried up the availability of these drugs on the street (which was alot safer to abuse) and this caused all those on the street abusing oxycodone to switch to heroin/fentanyl. This ain’t oxycodone and that has led to the massive amount of overdoses. So it was the lack of prescription drugs that caused todays problems and it started around 2012.

I certainly hope you mean to say this is your opinion based on your experience in whatever part of country you live, because the statements don’t pan out to the facts.
While Heroin and Fentanyl are what’s causing the deaths, it’s dubious to say the reduction of lortab “caused all those on the street abusing oxycodone to switch to heroin/fentanyl”. The problem is the low cost of illicit, Chinese Fentanyl is laced into Heroin and even knock-off internet Lortab and the Fentanyl is killing people.

What did you tell the new pain clinics as to the reason you were there. They had to know that you left another doc and came there, which by the way gets you labeled a drug seeker even though you just want what works

Mark,, loved the comment, everyone is different! Take me I’m a full blown pill addict who always has a job but would be broke not only on payday but two weeks prior thanks to yo being able to go on the books… anywho
I am on 90 mg of dome since 2012 I can tell you my quality of life skyrocketed have a fiance a vehical that is paid off which I completely get is second nature for most!! However in the seven years I have witnessed more than my fair share of waiting in line at the clinic hearing stories of how bad it’s going to be and how you’re going to be on it the rest of your life… I mean it was like many soap operas also here people say that you won’t even be able to think from the pain of yours hallowed aching joints for as many years as you’ve been on it if not more. Trust me I’m down playing the story I mean it’s been seven years you hear a lot of things.. to make a long story even longer I had run into a situation where I missed 17 days of dosing!!! Oh crap here we go 7 years of stories and and scary thoughts pouring through my head!!!OHHH here we go its been long time but I could never forget you misery you where such a big part of my life for so long.. now I’ve read about a hundred comments and I’m still unsure what this sites really about, I’m not here to condone or promote methadone,, truly I’m really here trying to find out ways to come by my treatment a little cheaper I mean 7 years that adds up just cuz for the majority of my life I would spend it within 30 minutes of cashing my pacheck it never got easier to see it go. But after reading Mark comments I felt I needed to say for the third time that everybody is different it wasn’t fun I had a crappy days I don’t need to go to the list of stuff everybody knows that always comes with abruptly stopping such a high dose of anything.. alright I’m going to wrap it up I’m back at the clinic now thank my lucky stars everything’s back to normal I missed it so much, I don’t lie to myself it’s going to more than likely be a daily thing the rest of my life Im fool apart from my run along sentences incorrect punctuation and horrible grammar I mean they did take a toll but I know my happiness comes at a cost probably will take 10 if not more years off my life but that’s years I didn’t have before… man that was a long story just to say don’t read into all the hype and trust me you will make it, Maybe. Have a good night

I just left the office of my new PM doctor. I was with my previous PM doctor for 7yrs. He retired @64, good for him, not me. I’ve been on oxycodone 30mg plus neurontin & topamax. My lowest pain level since a surgeon cut the nerves on wrong side lumbar spine, on meds, is a 4. I’m fine with that as I don’t feel anything will take the pain away. At any rate, the new DOC wants to switch me to methadone, pending a DNA marker test. The DNA test has me aghast. The thought of switching to methadone has me afraid. I saw how my ex responded to a short stint for pain. Then there’s the horror stories in the media. I moved to take care of my grandson. I’m also confused as to why a doctor would switch someone not tolerant or an abuser. This was my first appt! To me, he’s immediately questioning my other Dr. He stopped letting his patients use the CVS around the corner because the pharmacist questioned a prescription. Should I be worried? When you’re on this medicine, you feel like you’ve got a huge sign saying ADDICT. For me, I can live without oxycodone if I thought it was for better pain control. I can’t stand to take any more of them than is prescribed or I get sick. There’s no high effect for me so I’m not taking them for that. Any opinions, suggestions, or advice? Thanks in advance.

Deborah, I really can’t comment on your case specifically without all the information, and if if I had it, I can’t give advice via this forum. But I will say this; if your new doctor is very familiar with methadone dosing, it generally works better than oxycodone for burning / shooting pain because it blocks a chemical called NMDA. If your new doctor is testing you genetic type for cytochrome 2B6, that is a cautious approach to ensure you aren’t at higher risk of accumulating the “S” form of methadone. Perhaps things will get better for you with the new doctor, as it sounds to me like he/she may be on the right track. See 31.Zorn KE, Fudin J. Treatment of Neuropathic Pain: the Role of Unique Opioid Agents. Practical Pain Management. 2011 May; 11 (4): 26-33.

Please help me i am On 50mg metadone and 24mg Dilaudid for Break Though Pain Well I Am going To Be Out For 2 Days Of my Dilaudid because My Pain Was out of Control Bc i was Diagnosed With a new Painful Dieases called GOUT.PAIN Hands feet plus have CRPS RA PSORIATIC ARTHRITIS LUNG DISEASE NEUROPATHY NERVE PAIN ANXIETY AND PANTIC ATTACKS AND CHRONIC FATIGUE CHRONIC NAUSEA CHRONIC PAIN ON OXYGEN Just want to know will that Help plus on 0.5Ativan and Phenergan 25mg thank You

Methadone changed my life for the better. Well, for the best. I know these drugs work different for different individuals. For me, I was on Norco 10mg 4x daily and after being on that for years, it stopped working almost all together. The methadone made my life normal again. I could function so much better since I wasn’t focusing on the pain anymore. To each their own, but for me it worked great.

Thanksthat just happened to me last month. I was looking for how others felt after awhile and if methadone worked better than 4 Norco a day. I get 3norco for in between a ten methadone morning and same at night…. Thank you…. from Judy Zbleski Linder.

Don’t get on methadone! I’ve had 2 back surgeries and was on everything from oxycontin to fentanyl. Methadone is horrible! The stigma of it is awful and I wished I’d never switched. It’s the hardest thing to get off of too. Way worse than any other opiate I’ve been on. You should be worried and switch doctors now before he changes amything bc you wont get it back! Been thru this and the stigma really sucks! Dr’s talk to you like your scumbag drug user,very unfair but it’s how it is. Please read about methadone, it wasn’t supposed to be used forever or to manage pain. Thats just my experience, good luck!

U,don’t know what U R TALKING ABOUT! It doesn’t work for everyone but it works better for a burning stabbing pains WHICH I Gave CUZ I have A disease called INTERSTITIAL CYSTITIS. 60% of People with my disease Commit Suicide CUZ the pain is so…. horrible! Methadone GAVE ME MY LIFE BACK!

I am in the same boat. I have pain in the thoracic area of my back. 40 mg. Of methadone and I have my life back. The last Dr reduced me to 25 mg. Per day and its just awful. I try to save them up so I can take the 40 mg per day but its just about impossible. When I do save them up I just stop taking them and I do not have bad systems to this day. I wish I knew where to go for the fill amount. By the way, 40mg is not a lot and the first Dr that put me on it did EKG’s with a note ” for long term methadone use”. I wish he was still around.

Lori rn I totally agree with you. I also have a horrible very painful disease r.s.d and I hate when people don’t know what they are talking about. First of all they probably don’t even know methadone was made primarily as a pain killer during ww2 bc allies cut off the German opium supply so they had to come up with a synthetic pain med now known as methaone,dolophine,or methadone but a lot of PM dr.s use methadone for pain not bc ne or she thinks of u as a junkie or whatever ever else deziray put. It’s a essential tool in PM dr.s arsenal and if pharmacies give u a look or whisper to one another bc of your script $%&* them

Thanks Lori cuz I was going to say the same thing I have Crohn’s and lupus disease and methadone has saved my life and it also has given me my life back not having to worry about changing the patch on my body every 3 days or taking pills every 3 hours it’s one dose a day and I’m not paying free but I can live with the pain I do have. thanks and good luck to you in the future

This is so true. As wonderful methadone is for pain it is also evil. When i went to my first pain doc i was on oxycontin and it worked fine, but he uses methadone. I had no choice. Now 7yrs later of 20mg a day of methadone he switches everyone to the lowest dose of Embeda 20mg and 9 wks later im still having severe restlessness period from being taken off Methadone. They don’t care. “it will get better”

Been on methadone for 18 years ..went from 40mg a day to 25mg , it was no cake walk.I cut it back from 15mg to 10mg because of constipation problems from Colon cancer.After I got past 15 mg I entered a living HELL now for 26 months with PAWS..Methadone and Suboxone the 2 drugs made by man to help addicts is a worse and harder addiction to withdraw from than the drug people are addicted to.I know people who craved for 3 years straight every day like me and they went cold turkey. I am still taking 10mg and have had PAWS for 2 years ..This stuff is poison. Most will never get off either .it’s harder than opiates.

Get a different doc. Do not switch to methadone if you are not addicted. Methadone has helped me a lot but with methadone you have to go get it EVERYDAY. Only addicts should need that structure…it would be unfair to make a non addict go through that. And I am pretty sure a doctor cannot tell you which pharmacies you may or may not use. I would report this doc if I were you…

If you are a pain patient, you shouldn’t have to go to a methaodne “clinic” daily? Your pain doc or primary doc should be treating your pain, even with methadone. Those daily clinics are for heroine or drug abuser/users, who need something to get off of heroine (usually, although some may be addicted to and buying other opiates off of the street. Any real patient in pain should be at the government “metbaodne clinic.” This is absurd, your primary doc should be competent enough to treat your pain by gauging it through MRI, X-ray, your quality of life, etc. I would call my primary doc if I was you, because he is the one who switched you, right?

Zach- i’m Not sure where you are located or what dosage you are on but I am located in Oregon & on Methadone & I don’t need to go to a clinic daily. My dr prescribes me 40mg daily of Methadone & I get a prescription monthly. (However any dosage above 40mg daily- then yes a daily trip to a Methadone Clinic would be required)
My Dr. actually calls it into the pharmacy so by the time my visit is over I swing by the pharmacy & my scrip is ready to be picked up.
p.s. I am on Methadone for pain management not addiction.

My spine was broke in three places.both knees crushed and dislocated both shoulders..after 26 surgeries..I said no more..so mess was my only choice..After years of rollercoaster pain…I was put on opanol 40 MGS twice a day plus norcol for break thru. Two months later increased opanl to 40 mg 3 in morning and 3 at night..for over 15 years..life was pretty darn good..business was good.travel the world.wife family dogs etc..the Jan 1 2018..no more meds.they cancel opanol and insurance will not pay for generic..now..I cannot hardly move because of back pain and shoulder pain..what do I do. Does anyone know?? on scale 1-10..with meds I was a 3 atmost..now easy 8-9 an 10 sometimes…mayday..help..what can I do?

I understand what you are going through. I was in a life forever changing car accident in 2004 and I have had 14 levels of my spine fused anterior and posterior from T5-T12 & L1-L5/S1. I also several major nerve surgeries in my spine/spinal cord, and also several nerve surgeries in my legs from various nerve crushes. I had a total of 17 back surgeries, 4 nerve surgeries on my legs. I have also tried on 2 different occasions the spinal cord stimulators to help with pain in which failed miserably on both occasions. Some people had good luck with the stimulators. I am having issues with the insurance companies as of January 2018. I was just changed over to taking Oxycodone 30 mgs immediate release every 6 hours as needed & Oxycontin 20 mg delayed release 1 every 12 hours. It worked very well and the insurance company paid for it ,for the past 7 months. Before that I was taking one 30 mg Oxycodone pill every 3 hours/8 per day. Finally found something that worked between short acting and long acting and now the insurance companies are hurting us.I am now in your situation by being forced to be paying out of pocket for what I need and I,do not have $900+ per month for Oxycodone(4/30 mgs pills daily $250-$300 per month)and Oxycontin 20 mgs($600.00 per month for 2 daily). That is very steep when you have a mortgage and a family to support. Now I am trying methadone 10 mgs 1 every 12 hours and morphine 15 mgs immediate release 1 per 6 hours ,because they are much cheaper to pay for out of pocket($50 for the morphine & $25 for the methadone at the above dosage) for the entire month is great. So far so good with the new medicines. Lets hope it lasts and continues to work for my back pain. My neuropathy in my legs is a whole different issue and nuerontin 300 mgs pills/ 4,500 mgs total daily is not cutting it anymore. Any suggestions.

Scott H,
I’m sorry you’re in so much pain. In 1989 I fully dislocated my left foot. I had previously had a bad compression fracture of T-12 and sternum. After several surgeries to remove repair and reattach my foot needless to say it hurt constantly. I was in the Bay Area and found a wonderful doctor who got me off the big pharmaceutical expensive meds. He put me on methadone. It quite literally saved my life. I’ve been fully employed since 1998 raised 6 kids. I was on 180mg/day but I also was constantly ‘weening’. Even having a C- spine fusion just three years ago I kept up on my meds. I was always Trying to see how little I could take to get by. My doc found me a new doc to take over my case prior to moving to MT in 08. I was with him through September of 17 when, while I was in Houston doing flood damage work he closed his practice with little to no warning. Upon my return home I was devestated to learn this. No what? Montana has few providers. So I found a methadone clinic in Bozeman. Track one down and see if they can help. These folks here know what they are doing and are led by a very good doc who is an anesthesiologist/ pain management doc. We all need to stick together, form a lobbying group. The opioid crisis in this country is mainly due to illicit use of heroin or misuse of RX drugs. It’s not use who are responsible working folk. I was on RX Methadone for 17+ years and was fully functional. No early scripts, same drug store the entire time and no ER visits.

Scott, if you check out Good RX 120 x 30mg oxycodone (Roxycodone) is about $45 at most pharmacies. 60 x 20mg Oxycontin generic is $138 at walgreens. Again these are coupon prices using the Good RX app on your phone. You’re paying WAY too much!
I take 200 x 10mg of Methadone that i pay for out of pocket at Costco each month. 2 sealed factory bottles of 100 pills cost me about $40. Studies have shown that the analgesic effect of Methadone is about 8 hours, even though it prevents withdrawal symptoms in addicts for @24 hours. So 12 hours is stretching it. You WILL become completely addicted and dependant on methadone, but I wayed the pain relief against the fact that i’d have to take it the rest of my life, and leading a normal life won out. You could take up to 20mg 3 times a day and pay less than $2 day for the meds. I also take Dilaudid 4mg x 120 / month. both prescriptions together are about $65 at Costco using NO coupons. Costco is often 1/10 the price of other pharmacies. It just goes to show you how much pharmacies pay and what their markup is to the customer.
My pain provider writes me 3 prescriptions for each drug on each visit. I only see him 4 times a year. I take a UA once a year that costs about $150. Still, a good deal.
Good luck to you my friend.

Mark, may I please ask what state you are located in? I ask because I was told by my Dr. that if I am in 40mg daily of Methadone I can not be prescribed anything else to help with pain. Occasionally I need something for break through pain but now am just suffering through bad days. I want to figure out if it’s a state law or just my Dr’s office being restrictive with their policies.

Mark: what state are you in? I am in California and can’t get any doctor (I’ve been to 8 pain clinics) to give me any more than 3 10mg of methadone every 8 hours. That just doesn’t control my pain. I was being prescribed more before I moved to California, but it is my understanding that the CDC (Center for Disease Control) got involved and told all the pain docs in the U.S. that they could only prescribe 90mg of morphine equivalent per day. I am prescribed 3 4mg Dilaudid per 24 hours and the 3 10mg methadone per 24 hours… and it just doesn’t help except to maybe take the edge off. I have been reduced considerably over the last year. All of my lumbar spine are herniated, I have terrible scoliosis now due to my herniations, spondylosis, degenerative disc disease and on and on. I am in terrible pain 24/ 7 and now, I am getting sciatica 2 or 3 times per month! (I used to get it only 1 or 2 times per year). But apparently, the herniated discs leak proteins out onto the sciatic nerve causing sciatica. It is some of the worst pain I have ever had in my life and I have had 2 children and encephalitis where my brain was swelling when I was in a car accident and had subderral hematomas. This new sciatica pain made my blood pressure go up to 200/100 and I was throwing up all over the place. THe pain doc gave me some SI Joint Injections but that didn’t help at all. And so, with so much pain, I was forced to take some of my regular back pain meds – – which I just HATE to do because now, I will run out of medicine before the 30 days is up. I don’t know what to do!! So, that’s why I ask what state you are in because I would be so HAPPY if I could get 200 10mg methadone every 30 days. This would really help me. – 90 per month is just not enough. I have no quality of life and feel like jumping off a cliff half the time.

Hear u about the nueropathy- gabapentin n lyrica do very little. Pain n burning made me want to commit suicide. I’ve had pain for 15 years- in obky 47. 75mgs of methadone helps.Couldn’t find a Dr prescribing it so i am a “drug addict” getting it from a clinic. But hey y do what u have to.if u ever want to talk hit me up amys3269@gmail.com

Your primary doc should put you on something? My insurance quit paying for my methadone (6 back surgeries, w/ methadone still at a 3+ with pain, meds help, but it’s hard to completely have no pain) so I pay cash. 90 pills (30mg daily (3x10mg), And it’s only $28. Your doc should be treating your pain. Ask him about methadone, norco….any of them should help to a point and take you down from an 8 to something else…anything is better than an 8 for pain! Good luck!

It dosent have to do with toleration or abusing meds. They like using methadone because its longer acting and it does work i was taking morphine for years that barely worked decided to go methadone its the reason i csn move today. Dont be afraid although as you said everyone tolerates differently but most of the time it works well.

Don’t be too afraid. You will not be in pain with either option….so that’s out of the ay. If you are only on 30 mg oxycodone and your not tolerant to them than I would not see why the doc wouldn’t stay with that. It is not asking for much. Methadone works great for pain but you will have to get used to it like any drug BUT the BIG problem is that you can’t miss a day or 3 (max)!!! I would get 120 a month even if you only needed 90. You NEED to have some extra day supply in case of an emergency. I have heard of people getting locked up in jail and had to TOUGH it out on 80-300 mgs COLD TURKEY. It has worked much better for me when I did not have insurance since methadone used to be dirt cheap buy it’s getting more expensive in 2018 for whatever reason. It was something that lasted all day long taking it once a day (you can split your dose to twice a day and I might do that to start so you get used to it if you get sick from to much pain meds normally. I would recommend asking for 90 10 mg percs instead of 30 mg oxycodone or switching to 120 lortabs a day Your doc should be fine with that or go to a time release 40 mg oxycontin or opana ….which would be my choice over switching to methadone. Tell the doctor what you want, why you want it and why you don’t ant to be stuck on methadone. Hope this advice helps from a guy with 30 years of severe back pain. Good luck!!!

Michael – I’m surprised you are able to get that much methadone and even more surprised that you are able to get extra in case of an emergency. Where are you? Which state? It is my understanding that the federal law (which for some strange reason was written by the CDC – Center for Disease Control) says that doctors cannot prescribe more than 90mg morphine per day. So, you have to figure out what the methadone equivalent is – but I was told that to reach that 90mg morphine – I can only have 3 10mg methadone every 24 hours (per day) and 3 4mg Dilaudid per day…and I certainly don’t get anything for emergencies. I have had the worse sciatica for literally 2 months nearly nonstop and my pain doctor would not give me any more pain meds. So, I was forced to just suffer and when the pain was the worst, I took a couple of my regular back pain meds, being stressed out the whole time because I knew I would run out before the end of the 30 days. Right now, I don’t see the pain doc until May 5th – my prescription 30 days is up May 6th (the pharmacy won’t fill early) – – and I will run out of medicine on April 28th – OMG – I don’t know what to do!!

U all r very lucky. All docs are being pressured to cut, cut, cut. Get mentally prepared. I should never have to say this, but if some pain docs weren’t so cruel i wouldn’t have to. If u are taking your short acting med 4times a day on good days u might want to only take three and put one back for when the day comes your doctor cuts everyone to the lowest dose without consideration of withdrawal. It happens. In Wv nobody writes any high power stuff anymore

Hi,
I have the most SEVERE nerve pain all over my face- it effects my eye lids, eye balls, lips and teeth. It’s horrible. I tried LOTS of meds to no avail. Percocet didn’t touch it, like taking water. Then methadone- it changed my life. Brought my pain down from a 10+ to a 4/5. Suddenly I can do things again. This med is not just for addicts. It has a longer half life than other opioids so it lasts much longer and gives much better pain relief. Go sow and you will be okay. I started on 5mg and am not on 30mg which is the limit at my pain clinic. Good luck and god bless

I was so scared to take methadone I had 3 very little girls. 2 3 and 5 and I wanted to be there and remember every minute!! My doctor was from the Mayo clinic and I promise you will love it!! At 1st it feels strong like the 1st 3 days then you are wonderful!! Your boyfriend should have never been on it short term.

Hi Deborah I was on the same pain medications for 15 years and I have been seeing my current doctor for a little over a year about 6 months into seeing him he brought up methadone to me for pain management he thought it would work better then having to take all these pills every couple hours so finally a little over a month ago I gave in and I can honestly say it works a hundred times better than the pills and the fentanyl patch that he had me on. I had the same thought that you did that only addicts use this medication but it’s not true what I did first was research the medication and I think you should do the same and you would be amazed at the information that is out there. good luck and I’m telling you I have Crohn’s and lupus disease and being on methadone was the best decision of my life

I am a Disabled Veteran with Severe Chronic Pain and taking 50 mgs. Of methadone a day. Regardless of that this whole opioid epidemic has been caused by either drug addicts and/or people who abuse their medications. All of the legislation that is trying to get past or has already been past will do nothing to stop the abusers. They will get their drug of choice regardless. The only people these laws are gonna hurt are us, the people who don’t abuse our medications and who desperately need them in order to be somewhat functional.

So true I’m 29 years old I’ve already had 2 back surgery’s and looking at another I have 2 herniated disc pinching my Sciatic nerve and 2 bulging disc in my upper back and kyphosis Because of all of this crap my pain dr is scared and has lowered my medication so much that I can barely function during the day I’m only 29 years old and have to live with my grandparents to help me in no way is that right!

Hey Paul I just wanted to say I read your comment and I know exactly how you feel and what your going through! We have very similar situations . People in pain that need these medications need to organize and stick together because our power I think is in our numbers . I recently joined A couple groups on Facebook in my hopes of connecting with people who know the struggle and want change to come let’s hope it does soon

John Doe, I cannot give medical advice via this forum. If your doctor wishes to discuss this I’d me happy to speak with him/her. However, I will say that several states have different methods of calculating methadone equivalents and the accuracy is lacking.

John doe- Like you, I have been caught up I the crossfire of Maine’s new drug laws on opioids. Two Maine legislators, Jim Dill and Geoff Gratwick, are working on a plan to somehow exempt chronic pain patients from the new law but, based on what I’ve seen thus far, it will be as screwed up as the original bill. Senator Dill indicated to me that the 100 mg cap will remain, but there will be a screening tool for doctors to use to see if patients will qualify for a higher dose. Dill seems to think that Gratwick, who is a physician, is knowledgeable about chronic pain management. It’s been my experience that most doctors have little to no training in chronic pain management. I tried to tell Senator Dill when they were holding hearings on this legislation that pharmacists, not doctors, are the experts. This is exactly how the government screws up anything it touches. This all started with Governor LePage, who probably read an article in Reader’s Digest and determined people in chronic pain don’t need opioids. I saw the handwriting on the all two years ago and started weaning my Methadone SLOWLY. I started at a dose of 30mg/day, which is 240 opioid mg (based on what my Dr. told me). The Methadone dose I needed to reach was 12.5 mg. You really need to talk to your physician to get his/her guidance before you attempt to decrease your dose.

I guess that’s why prescriptions are written by doctors? They are all just suggestions from the doctor who went through medical school and can tell you things about the body a pharmacist would only know by reading wikipedia (or readers digest$0) . The all knowing pharmacist(who has no real medical training beyond what you would find in any combat medic, actually probably much less training on anatomy and physiology) than takes an experts with medical advice, training, and experience in the real world and the pharmacist then tells the patient what to really do next tske. Is that the way it works? I was just at a pharmacy last week and the pharmacists (like always) fills what the doctor put an order in for me to take, maybe it’s because they know as pharmacists they should trust the head of enterology and the head of psychiatry over their own personal anecdotal opinions. I threw in anectodal just to help,save face as most pharmacists just use the “I know what I’m talking about approach to logic”. Kind of like the one you just made.

My guess is 100mg of methadone doesn’t translate into anything else. Unless the bill specifically mentions it I would take the law to mean that a doctor who isn’t a qualified pain specialist can’t prescribe more than that amount of methadone. Kind of like the federal suboxone program, a doctor needs to be accredited to prescribe it. And even then most doctors can only prescribe to 28 patients. I believe exceptions exist but most doctors on the frontline are general practitioners who were never designed to be experts in anything but mildly competent in everything. They are mainly there for things like the flu, bacterial infection (tat is manageable with antibiotics), vaccines, annual checkups, blood results, etc. They were never meant to do more than that. Which includes comprehensive pain management. My doctor will prescribe 20 Vicodin or Percocet if you took a bad fall. Maybe even write one refill. But after that he directs patients to specialists. Because general practitioners shouldn’t prescribe painkillers, antibiotics, etc so easily. I’m glad doe the new laws. It means patients can no longer bully a doctor into giving them what they want, all the doctor has to do is point to the law and say take it up with your representative.

You would think it would be hard to bully a doctor but it’s not. It happens often (the patient doesn’t need the medicine) and the doctor gives up because he makes much much less (family doctors make much less that is) to deal with ashokes than the average person thinks.

Chris, Your comments about pharmacists couldn’t be further than the truth. They have just as much school as physicians and far more education on the pharmaceutical sciences and related research and interpretation of that literature. A PharmD requires equal years of college compared to the MD. And, this post you read about methadone and the linked articles were written by me. I’m a pharmacists. See Is There a [REAL] Doctor in the House?.

Dr Fudin…I absolutely agree with you regarding the knowledge level of pharmacists, and their integral part in patient care. My experience has been that my pharmacist is a great resource for accurate information/advice. I have been prescribed many meds that my pharmacist realized did not safely mix with my others or were not appropriate given my medical conditions. Many physicians prescribe without opening a PDR, and they lack education about these pharmaceuticals. Cheers for Pharmacists.

If I want to do the 7 day taper of methadone starting with the 30mg then 30 then 25 then 20mg etc is it safe for me to take if I can take up to 40mg of oxycontin twice a day and 30mg roxicet up to twice a day? I just want to take a break from the opiates to get my tolerance back down would it be safe for me to start at the 30mg dose to do the taper?

Jeffrey,
I never wanted to be on methadone. Yes its a good pain medication, but after 8yrs of 20mg methadone 10mg bid my physician switched us to Embeda 20mg Qday. On the positive I can finally get off the couch meaning I have energy again. The problem is I am having severe restlessness that was just occurring about 2hrs late a night. Its now occurring day and night and its horrible. How long does this last. Im in week 8 post methadone. I also take Tylenol #3 qid

I am a chronic pain patient. Six spine surgeries and a hip replacement. The Spine Surgery ctr at Mercy Hospital wanted to operate due to severe stenosis two places, breach position of two pedicle screws, cage retropulsed into my canal….my entire lumbar spine has collapsed and same happening in cervical spine. It was determined the risks of surgery outweigh benefits. They and Portland Pain ctr both say I am not a candidate for any interventions…. I’ve failed them all, and I can only be managed pharmaceutically but they don’t prescribe opioids. So they both feel I am an exception to the dose limit. My Dr, however, believes I can learn to meditate the pain away!!

When the thinking was “give em all the opioids they need”, Boston gave me every med u can imagine. At one point twenty years ago, they decided to switch me to methadone…started at 90mg a day. Moved to Maine 15 years ago and primary care Dr took over. Eventually, I got up to 240mg.daily. AND THEN… VOILA’…. attitude changed….Drs became fearful of the law, and patient care took a back seat.

I have now been weaned to 35mg daily, and just today from that I was converted to 90mg morphine. The state legal equivalent of methadone to 100mg is 20mg. My Dr looked it up on the Maine Medical Assoc website. This has destroyed my level of Independence and functionality. I am such a small part of the person I have always been. I read changes to the law that allow patients with severe neurological issues/spine disorders, can be placed under the palliative care section of the law which allows higher dosing. Good luck finding a physician willing to do so. They all want to be done with prescribing narcotics. If anyone knows of a compassionate/empathetic physician as it pertains to this issue (in Aroostook County) please share information with me. Opioids have allowed me to raise a family, care for a bedridden husband for ten years til his death, and earn a living between surgeries. Now I am 60….finally my time to live and enjoy life…..and this happens. I’m sorry for ranting, but I’ve faced more than my share of struggles/challenges, and done so gracefully and with dignity. I truly understand ppl taking there lives due to this. Scope showed extremely raw stomach lining and old blood due to 12+ aspirin I am having to take daily just to be able to walk……but that is medically sound treatment???? It makes no sense to me that medically trained professional are making such destructive decisions for their patients. I will learn to meditate this pain away? Are you freakin’ kidding me. Thank you for giving me this venue to vent my frustrations, fears, and utter frustration. Lori

I feel your pain. 4 fully ruptured discs has left me with neuropathy from the hips down. My old pcp had me on huge doses of Oxycontin and Morphine. I started seeing a pain specialist a few years back, who immediately switched me to methadone and starting bring the dose down 5 mg per month. Three years later, 30 mg of methadone is my maintenance dose of 30mg. Three years later, my medicaid decided out of the blue that starting 4/1, Methadone was for addicts only. *428, they said they had given me sufficient time to find another med and denied my prior authorization with no appeal. The last week 1ve tried 2 other long acting meds and wound up in the ER with migraine, seizures and chest pain. We’re not at the point in AZ as Maine, but I see it coming, considering as a country we have 3% of the total world population, but use 80% of the painkillers (by 2015 numbers, latest I could find.)

I would love to hit who says that on the thumb wth a 5 lb hammer and then in a nonchalant way sugget meditation for their pain while also handing them a pamphlet on it.They may only then get the idea as to their stupidity……

The pharmacist knows the drugs and equivalent dosing. Don’t have that much faith in all physicians. As a health care person dealing with emergency and critical care I can tell you that there are good and bad in all professions. You can be the smartest person in med school does not mean you are, or will be a great doctor. Some are bad at putting theory into practice and others don’t stay up on changes. Some paint everyone with the same brush regardless because its easier. One stamp for all. You probably know more about pain medication and dosing and equivalents more so than your doc. Unless you have a great one.

Thanks for seeing how awful our situation is. I’ve suffered from various chronic pains for over a decade & it was only after nearly dying from a GI bleed from NSAIDS which caused my MD of 5 years to try fentanyl…. then took till 2014 & 5 more MD’s to get most enough so my pain was tolerable with the 125-150mcg fentanyl q48 hours doses but that was also when my formerly misDX’d “faux”bromyalgia ramped up & was unbearable till switched to 20mg methadone every 6 hours in 2017! I was getting good relief from everything else but only 20% or so from what would prove to be biopsy + NLD-SFN with primary AutonomicNeuropathy (which r/o fibromyalgia once & for all) 50% relief of ny sero-negative rheumatoid, psoriatic & osteo arthritises, osteopenia, >10 yr chronic Occipital neuralgia with autonomic & migrainous features, and 95% relief of my surgical nerve & GB damage. I also have CVIDS formerly misDX’d as CFIDS & severe adrenal insufficiency & various autoimmune d/o. It has been pure torture to have NEVER been “titrated to effect” so I’ve never had “breakthrough” pain so take 1 hydrocodone10 every 6 hours, too. I am now being forced into invasive, last resort surgery for dilaudid intrathecal pain pump at 49 y/o all because Uncle Sam is practicing medicine without a license, gov’t agencies are interfering with Doctor and patient relationships by Fascist dictates that have zero regard for us or doctors. The rare pain MD’s who are willing to treat us with therapeutic opiates are so witch hunted & fearful they must do harm by allowing us to suffer or risk invasive procedures early & bad pain MD’s are given cover to continue their denial of pain relief or doling it out at their whim to play god over us or sadistically to enjoy our pain. I have been lied to (opiates won’t work for nerve pain”), bullied & shamed ( “who told you anything serious was wrong? We have 2 types of pts that come in here. Ones like a relative (aunt?) who was 76 with brain cancer, needed to have eye ablation, you could tell she was in pain but she never complained, never took a pain pill & worked till the day she died. THEN, we have pts like you. So, we are never raising you above 75mcg fentanyl q72hrs or you’ll just be in here every 3 months wanting more”…. Dr Chad Domangue 2011). I have had my childhood abuse & history of anxiety and depression used against me…. psychology should not be used as a weapon to deny pain meds & psychologists should not lie just to get $ “we have to document something to get paid”,nor give pain MD medical advice because of their own personal bias & discrimination against opiates. I’ve even had 2 false imprisonments…. 1st forced into outpatient rehab in an attempt to brainwash me into believing I didn’t have pain & 2nd an ER trip when a rogue nurse practitioner unbeknownst to my only good pain MD sent me as a suicide risk after saying all opiates were not only NOT going to be increased despite “oh, we KNOW your nerves are dying” but would be stopped over a weaning period so I merely said “Well, I am going to die” meaning of secondary complications of untreated extreme pains, the ER doc released me after I said I just needed an advocate with pain mgmt, no active plans to suicide but would not survive weaning as my neuropathic pain alone was unbearable NOW” so, he said” If you are going to kill yourself, you’re going to kill yourself” & D/C’d me. Next time at clinic Dr S said he was switching me to methadone & 10mg ketamine if Trileptal again didn’t help. That rogue NP instead fired me llegitimately, Sept2014 when said therapist quit but very glad DrS was switching me, I needed new names in my insurance….she said “No, we are weaning you off everything” “But therapy was mandatory. You’re done”…. she lied , documenting I made no attempt to undergo therapy but had seen 4 providers! And I said DrS must not know who I am unless he sees me but the other nurse who’d been called in said “Oh, Dr S KNOWS who YOU are” & they said he would not see me. I spent 2 years learning most pain MDs care nothing about decreasing pain, only pain meds. There are only hurdles & roadblocks stopping opiate dependent pts from accessing care, it was very likely I would die in ER or rehab as just an acting out junkie. What a vicious circle of Hell I endured, saved ONLY by a nephrologist friend ordering methadone then my primary, then a retiring pain MD & educator who increased it to every 6 hours as that is how long it helps pain despite long half-life which is good for addicts. Switched insurance to see a great Pain M.D. Feb2017 who then lost his license! I had seen MD who misDX’d OIH & considered addiction & dependence 2 sides of same coin who sent me to psychiatrist who referred me to an inpt detox for methadone & also to SAMSHA. Inpt detox said “you’re a chronic pain pt. You don’t want to come here. We are against methadone but that is your best bet”. The methadone clinic said ” It isn’t like we don’t get abandoned pain patients but you aren’t an addict. We can’t help unless you are….you get into legal trouble, stealing scrpts, etc” Since both referrals suggested methadone I asked initial MD, Harrison, if he would reconsider his no methadone policy & he was angered, refused to see me at all, despite admitting I wasn’t an addict referred me to several providers who exclusively treated addicts & used short term Suboxone! Another pain MD did ketamine infusions but said she’d “never order opiates” for me due to history & I only needed CBT. A psychologist at a huge pain clinic listened to my story fot over an hour. Dr Bolter said “It is absolutely ridiculous to think Cognitive Behavioural Therapy can help you with all your physical problems” & he referred me to an MD who he send “patients like” me, too who did med mgmt…who was not on my plan & he had been “raided” by FED….found article with patients figbting for him & saying he saved their life when everything else failed. Saw 2 neurologists, both supposedly expert in polyneuropathies, but neither interpreted my Therapath Lab biopsies right & both were anti or opiophobic. Dr England said “SFN normally doesn’t respond to opiates” despite it working for mine & being the normal treatment! Both Dr Gutierrez & England thought I had less sweat glands instead of obvious SFN due to loss of sudomotor fibres which ennervate sweat glands. I am in the 18% of SFN pts who according to research are negative on the more frequently done Epidermal Nerve Fiber Density ENFD Bx which they thought ruled out my positive biopsy! But Therapath said “no”, that the “SGNFD is an earlier & better indicator & can Dx SFN alone”. I begged them to get in touch with LSU neurology, teach them how to interpret, get them to audit charts since up to 18% of pts like me could be misDX’d! “Can you at least send them something”? Therapath actually said “No. It is in your lab reports & in our research”. They did refer me to a neurologist able to Dx over phone after faxed. But he wouldn’t even refer to pain mgmt! SFN especially like mine…patchy/non length dependent, is often believed to be somatoform/ conversion d/o and being one of the most painful conditions next to cluster H/A has sent pts to psych wards & morgues as suicides….biopsy is SUPPOSED to get us believed & treated but psychologists blew me off as catastrophizing despite having multiple, catastrophic diseases! I was out of options & my DrS had a new clinic so I went….he said that rogue NP fired 1/2 his patients b4 he knew. He didn’t know what she did to me. He is continuing my methadone despite uncomfortable with my dose despite being the lowest of the 80mg-120mg target range for neuropathic pain as we try to get pain pump. I am so lucky because who would ever believe me if he hadn’t taken me back! I edited TONS out, too of this saga!
It is evil that in the greatest country on Earth a literal holocaust is occurring & even the victims may not know or are made to be too fearfil/ashamed to ask for therapeutic opiates when interventional & lower tier meds fail or don’t work well.. People who have incurable disease &/or permanent injuries are denied pain relief, may be forced to self-medicate and lose support systems by being treated like a junkie or if they endure thr pain may suffer heart attack, stroke, adrenal crisis & die from secondary complications from the stress of living in agony. The new mantra of “Pain won’t kill you” & hearing “Vee haff very gud studtiez to show dis” where from? Nazi Germany? Lies since any layman knows stress kills & nothing is more stressful. We are treated like liabilities, like a waste of time, like parolees seeing parole officer & endure multiple treatments/meds some may help a bit but most are even worse….if we are lucky may get a little relief while we jump through hurdles going after the carrot on a stick, but if we ask or if we get new pain or if we change doctors that stick is taken away & we are kicked around, office to office to become some other doctors problem. Now with CDC falsely manipulating statistics & a frenzied media brainwashing campaign demonizing an entire therapeutic class of meds has made our lives even worse. They should just be honest and admit this is a death panel & legalize assisted suicide for persistent pain victims. There is hope overflowing for addicts but no help for those of us who require life long therapeutic opiates at adequate doses to survive otherwise unmanageable agony. People shouldn’t be forced to commit suicide. Even worse, forced to live in agony. MDs can’t do what pain mgmt textbooks, PDRs, med schools, journals teach but must decide our treatment & doses based upon what some bureaucratic agencies decided? Even if panels have doctors they are not our treating physician. Why aren’t doctors up in arms & fighting back for them & us? And, for themselves to be protected…if someone lies, slips through, ignores orders & hurts or kills themselves the MD shouldn’t have any legal ramifications….civil or criminal. Why are our laws always about protecting the criminals & punishing the victims? And, chronic pain victims should be able to waive any liabilty for themselves or their estates & choose a possibly shorter life over better quality life. Instead, we have our right to the pursuit of happiness impinged upon by our own government as they promote & even force us to be discriminated against when our disability is chronic pain that requires opiates to be properly managed. If there really is an opiate OD epidemic…. the addicts shouldn’t be preventing our care. With basic rules in place, offering help & treatment but allowing addicts to suffer the consequences of their actions will help them hit rock bottom, sooner. And, if they OD, should have to pay for the treatment unless they enter rehab. If they fail rehab, they shouldn’tt get free ER care, anymore. If they die, their bodies should be considered taxpayer property & used in research, for the common good. Instead, due to their expenses for a selfish lifestyle, good/contributing citizens must suffer & die & doctors have to suffer frivolous lawsuits & even pay or get criminal charges? Bizarro world.

Oh, even palliative care programs are scared….been turned down by 3. They sound like the answer yet feel as restricted as everyone else except hospice.

Forgive me if I post twice… don’t want to just hide 2 hours of writing in a reply to a comment but ascana comment, too. Heh…. too long for most to read, anyway!

Jason – I completely agree with you that she was OVER THE TOP! Good Lord –

. Lynne I’m sorry if this is insensitive but you sound like a lunatic. The novel you wrote was so ridiculous I had to quit 3/4 of the way into it. If you truly are looking for honest & constructive positive feedback I would suggest taking a long look in the mirror & taking ownership of your situation. I don’t think anyone is going to take you seriously because the of the non-stop ranting.
Just as a suggestion try to shorten your venting to a SHORT paragraph if you actually want anyone to take you seriously.

You bet my comment was over thr top! Trying to condense just the past 12 years of Hell from being forced to live in agony while being ignored, lied to, bullied, misdiagnosed, mistreated & harmed by the people who are supposed to help us is impossible. I have been leaving messages I hoped would help others like me since there is a high likelihood I will be gone, soon. Addicts need not soend time and energy and money attempting to get proper care at the proper places. I SHOULD consider becoming one…. certainly MUCH easier, cheaper & less demeaning to get street drugs than face physicians with attitudes like yours. No need to read anyone’s comments & leave useless posts to further kick someone already doen.

I was on methadone for over 6 years and it was the hardest to get off of without any side effects. I was taking 3-10 mg dosage each day after back surgery. I could not function on Hydrocodone 10-325mg three times a day and morphine 10 mg once a day for breakthru pain. I had a two stims put in one for upper back and one for lower back. This helped my pain so much I was able to start working again. Long story short, tapering my dosage little by little until I got down to one 5 mg a day, and I was having horrible side effects and it took me taking Kratom and smoking weed to get off of it completely which took about 10 months to be off of all opiates. I still have had a hard time with pain management for other causes, but it still takes a lot of powerful drugs to manage my pain and I have been off of all pain pills for almost two years now. Does your tolerance ever go away or are your receptors damaged forever? I would love to just be able to take a aspirin or Tylenol or Ibuprofen and it actually helped.

Dear.Dr.Fudin and team.
I’m a 40 year old male and at age 25 I enrolled in MMT at a clinic as an alternative to opiates I was being rxd for back pain. I’ve been on methadone for 15 years! Never more than 90mg daily. However,over the years I’ve found a WONDERFUL doctor who rxd the methadone from his office. I met him in 05 so I’ve been his patient for 13 years years and in that time he’s weaned me to 40mg a day..Very slowly..Like years. Recently he has sent me a letter informing me he will no longer be rxing opiates. My question is with me being down at a pretty low dose,will I be able to transition to another med?Even with me being on mdone for 18 yrs! My current doctor is suggesting Subutex but my pain management doctor is suggesting opana er but would I even be able to convert to opana?? I’m confused and not sure what to do. Can you please offer any advice? Anything will be helpful. Thank you very much.

Why do you have this site if you aren’t giving medical advice. Give it with a waiver. Nobody’s doctor is going to email you with our/patients’ questions. We are all in a horrible position due to the extreme morons regulating the industry and the new laws that presume everyone taking opioids is a drug addict. It’s horrible. Please help these people. Get a spine nd give some advice! Jeez….

It seems like this site is unable to help anyone. Unless you want some cold hard facts about Methadone-only-related opioid conversions, which is what someone would write their P.hD dissertation for. The people who actually need this information are in an unimaginably terrible situation and receive a copy-paste guarantee. I wish more doctors cared about their patients enough to at least write something personal, or offer an alternative to a phone consult that will never happen. Doctors help people. I thought…

Hello,
I am a 46yr old female who is disabled and been on opiates for 20yrs. I just weened this past year from 80mgs of methadone down to 25mgs and then switched to 200mg of morphine ER sulphate. Having said that, I had to take both 100mg tablets of morphine ER at the same time in the morning to still have quality of life. The 200mgs of morphine in the morning did satisfy me til the next morning with no detox in the middle of the night; therefore, opana in the right dosage would do you wonders I believe especially considering you get both morphine and oxycodone. If my insurance would pay for opana I would prefer over just the morphine. Good luck getting all the methadone out of your system; I had body cramps for a couple of weeks even still on the morphine.
Thanks
kfitz777

Definitely do the opana. One guy on here was on 40mg of methadone and was converted to 15 mg twice a day of opana and 15mg of Percocet four times a day. The subutex is useless especially if you have any nerve pain. Thanks and god bless

I am on 10mg methadone 2 times daily and 10mg norco 3 times daily. How safe is this in the long term? I have been on both medications for the last 3 years or so and the norco was adjusted from 30 10mg tabs per month to 90 10mg per month as i was hospitalized. I was also instructed by a specialist that i needed to get my anxiety/stress levels under control but my pain management doctor decided about 6 months ago thay 1mg lorazapam could have a terrible reaction with the methadone. I recently decided to give Lexapro a shot and its been about 2 weeks and i feel a difference as far as stress but my anxiety is still off the charts. Is there an anxiety medication that is safe to take with methadone?

Hello, I have been on opiates for most of my life. They started me on opiates when I was 16 years old for Crohn’s disease. And then I developed an addiction to them by my early twenties. I was advised that I should start taking methadone as an alternative to the opiates. I did this thinking that it would alleviate my addiction. It turns out that it was the worst thing I’ve ever done. I’ve been on methadone now for about 4 years and ever since I started methadone I started having seizures, a heart condition, and lots of other serious medical problems. I have since gone back to the pain management clinic and they want nothing to do with me. It seems as though after they cause an addiction and move you on methadone they don’t care about you. I need to get off of methadone. I believe that I am highly allergic to it as I can’t understand these major medical problems that have occurred since I’ve been on it. Additionally, I feel like I’m withdrawing on it everyday but I haven’t changed my dose or gone down on my dose at all. I can’t seem to get a doctor to help me to convert from Methadone to morphine. I have done some research and the only way that I can get off of methadone is by going to Morphine then to a less strong opiate-like Vicodin and then mmaybeto Ativan. If you could give me any advice on how to go forward with this, I would really appreciate it. I know that the DEA has come down really hard on providers prescribing these drugs however, I feel like there is a big conspiracy because they try really hard to get you on methadone and then they don’t allow you to get off and I believe that methadone is killing people. I think that there is something very wrong with methadone. I don’t know what to do. I am so sick everyday and I can’t take care of my daughter or myself or everyday life. I have been clean from drugs and alcohoI. Well I’ve never really done drugs besides the ones the doctors prescribed to me but the only thing I’ve taken in the past four years is methadone and I need to get off of it. So, if you can give me any kind of advice about who to go to to get help to get off of this or how I can make a doctor or force a doctor to wean me off of methadone by route of morphine-then Vicodin- then Ativan- and so forth, I would really appreciate it. This is life-or-death for me. Thank you for your time and thank you in advance for your help

It is obviously time to get another doctor or Pain management clinic. Methadone is a very good drug for many people. But as with everything, it isn’t for everyone. You could consider using a methadone clinic that will step down your dosage of the drug over time and along with counseling for addiction and of corse regular visits to your Primary Care Physician, you could possibly come of of the opiates. That is if your pain can be managed without an extended release pain medication. Long acting meds are better against addiction and abuse due to the consistent level in the blood vs the ups And downs of drugs such as hydrocodone/apap

Hi Jessica,
My name is Sherry and I became addicted to pain killers after I had My Son by emergency C section…It wasn’t bad at first but I Ended up with Post Partum depression…When my Dr stopped prescribing I began to buy them off others…then I realized I couldn’t go to work or go anywhere without having them…I lived with my Fiance at the time whome I absolutely Loved and adored we were high school sweethearts and were together since we were 15 and 16 years old…He was a Great Person and a wonderful Father…We were engaged for 6 years before having our baby boy born in 2004…we planned the wedding for October 1st 2005…We were finally going to be married and start our lives together…But…On The night of April 10th 2005 I come home from work to hear our son Screaming …imediately I’m thinking Omg my baby what’s going on I’m frantically headed to his room just passed our room and Suddenly it dealt as if I was in slow motion, I look to.my eft in our bedroom to find Timmy lying on the floor with his mom and Dad by his side His Mom looks at me and says Sherry I think Timmy is Gone…I flew over to him dropped to my knees and Screamed BABYYYYY…I’ll never forget that terrible awful scream echoing in my head and seeing him lying there lifeless…When the police and paramedics arrived they had to hold me down so they couof carry him to the ambulance…And off we followed sirens screaming when we arrived all the family were pacing back and forth…I finally asked the paramedic that worked on him if he was going to be ok…He said They did have a pulse…And we let our a sigh of relief…The Doctor comes in and pulls us into a room looked at us as I healed our 4 and 1/2 month old Baby and said…I’m Sorry we did Everything we could…But Has gone…My life stopped at that very moment All I could do was Scream and cry saying repeatedly OMG NO HE CANT BE GONE Begging the doctor to keep trying…She was Even Crying saying I’m So Sorry there is nothing more we can do…She had to sedate me…he was pronounced dead April 11th at 2:21am as the result of an Overdose of Methadone and Xanax…My Life has NEVER been the same…I know this is a long story but there is a point to my story…Hang in there…. That was the beginning of a Long Terrible Depressing Traumatic life that followed…I began using more and more Pain killers starting with Hydrocodone to Oxycodone and then anything I could get my hands on to dull the pain…Finally my family said Sherry you have to do something…and I knew they were right I couldn’t go on living like that and take care of my baby…So someone at worked spoke with me and recommended I go get treatment at the methadone clinic…At first I was like Hell No that’s what killed Timmy…so I tried to wean myself off of the drugs…After a couple of weeks I finally went to the methadone clinic starting at 25mg and quickly All the way up to 120mg of liquid Methadone…I quickly gained a massive amount of weight I was 145lbs when I began within six months I had gained over a hundred lbs and climbing…I was so severely depressed and there was nothing I could do I was trapped…I Tried coming off of it by myself twice…By the 4th day I Fealt like killing myself the worse withdrawals I had ever gone through in my life…I fealt like I was in Hell seriously…Well Finally I asked them to start dosing me down…Well that was a process that took a couple of days…by then I had changed my mind…Then I went to my family doctor for help…She said no way she wouldn’t help.me…By this time I had been on Methadone for 6 and a 1/2 years I had this rash all over my body arms legs face back stomach everywhere…Well Finally I had hit rock bottom I was miserable With anxiety and depression believing I was Never going to be able to come off of Methadone…I had terrible side effects from the medication I would find myself passed out on the floor not remembering how I got there…I had a Grandmal seizure…High blood pressure and high blood sugar…After living this way for 6 and a 1/2 years I decided enough was enough…I decided to go to the ER because of the severe depression and panic attacks and I had myself committed to the psyciatric hospital…After being there for a couple of days I Finally got the courage to tell the Psyciatrist my story and told him I couldn’t live like this anymore…I asked him if he would help me…He told me Absolutely that is the best decision you could have ever made He said we will begin imediately…So Finally they started dosing me at the hospital…but small amounts every couple of hours…and every day they went down on my dose but I couldn’t tell because I got it so often and they didn’t go down by much…They also out me on Blood pressure medication, klonopin for anxiety, So grab for Nausea which I didn’t need and Also a sleeping pill…On the 7th day I saw the doc and he said Congradulations the worst part is Over…I was like WHAT you can’t be serious…He said yes ma’am…but you’ll have to start seeing a Psyciatrist and a Psycologist out patient immediately after discharge…I was there for about three more days so they could observe how I was going to do without taking it… God as my witness I Never once had withdrawals… After I was discharged I started seeing my therapist and Psyciatrist regularly then like every 6 weeks then like every 3 months…I Never fealt so free l…I had My Life back….My Rash went away I immediately started losing all that weight…I just about lived at the beach that’s where I went to think and relax…I started talking to my friends again…I’m not saying Everything was perfect all the time…but no longer have anymore of the terrible side effects and I Have my life back in order and have been off Methadone since June 2013 and Never looked back..I think you should seriously consider trying the same thing if you are ready…I’m Sorry my story was so long but fealt like I needed to share it with you…Good luck to you!!! I enjoyed sharing my story with you…PLEASE Keep me posted…You can do this

Sherry,
Your story is quite familiar. I would like to share a story, which started in ’01 and exists today. It would end up being an extremely long story like yours, but I really am not in a position to post it on a public forum. I’m not sure how to get ahold of you directly or if you can get ahold of me, but I sure would like to know more about what you went through in the hospital.

Maybe the moderators can put us in touch with each other, if you are interested or would allow it.

Dear Sir, As Of Dec. 8th 2016 Dr. PHILIP R. MATTHEWS Had His License Suspended! I Found Out This The Day Before My Appointment (Dec. 23rd)
What A Nice Christmas Present From The State Of Washington! (I Believe The DEA Was Behind This In Some Way!) Dr. Matthews Has Been My Doctor For Ten Years! When I First Saw Dr. Matthews I Wanted To Get Off Oxycontin And Opt For Methadone. So For Many Years I Took Methadone, But Pain Control Was NOT As Good As The (Oxycodone) So I Started Taking Both. Everything Was Good Until A Pharmacist Told Me That There Was Issues With Methadone On The Heart! So My Next Visit With Dr. Matthews I Asked To Stop Taking Methadone. So, For About A Week Things Were Fine. Then The Nightmare Was Back! My Brain Kept Telling Me To Take More Every Two To Three Hours! (I Was Taking 12 30mg. Tablets A Day, 360 A Month!) So 6-8 Months Later I Asked Dr. Matthews To Explain The Risk Of Taking Methadone In Detail, And I Was Shocked! (I Thought The Risk Meant That I Would Have Had To Have Heart Surgery To Repair Problems Caused By Methadone! NOT!) He Said There Were Minor Risk And All I Would Have To Do Is Have EKG’s Every Few Years To Monitor The Use Of Methadone, And If A Problem Occurs To Take Less Of Methadone Until Things Went Back To Normal! So I Started Taking 5mg Methadone As Needed With The Oxycodone And Everything Was Great Again!
Great Pain ontrol And No More Chasing Oxycodone! Bottom Line, I Still Had About 150 Tablets Out Of The 180 10mg Methadone Tablets That I Had Stop Taking Around 8 Months Ago. And That Is What I Have Been Taking Since The 24th Of Dec. (3-4 A Day) But After Several Referral Attempts I Still Have NOT Been Able To Find A Doctor To Work With Me On My Medication! Any Suggestions? I’m Located In Redmond, Washington, And Running Out Of Options! I Don’t Want To Be Left Out With NO OPTIONS! What Would You Do?
AT A LOSS, Yours Truly, Wayne Young. P.S. Dr. Matthews Has Done Everything The State Has Asked Of Him, And Is Being Treated Like A Criminal!
He Has Had NO Fatalities, Overdoses, Or Medical Diversion!

Sherry thank you for sharing your story. I lost my brother to o.d. A couple years back and I’ve been on methadone for 16 yrs. I’ve never abused it but I do have chronic pain and now Dr.s don’t want to prescribe enough to help with the pain I’m in. I’m probably about to have to have another surgery to correct my cervical kyphosis since the last butcher for a surgeon screwed my neck up so bad. You have been a Inspiration to me to just know it’s possible. Thank you and may god bless you

Where do you live I’d like to see the Dr that helped you I am on 300 mg of dilaudid and extended oxycontin since 2010 I have CRPS and see a pain Dr my pain levels are at or above child birth on MCgill pain scale. No matter I want off the opiates I’ve been sober for 32 yrs and still consider myself sober as I’ve never achieved a high from my meds. CRPS is called the suicide disease many celebrities have it some recently have died Prince, robin Williams, M Jackson to mention a few notable ones. Help me if you can.

Jess,
I feel every bit of your screaming receptors, I know exactly what you have, what you are, and possibly what you may go thru. Now, quickly, I was started 2005 by a foremost sports med Dr, an awesome Dr at a low dose of 30mg. Knowing my body, it would quickly demand a raise of MDone, the Dr moved due to the worst town he’s been in to practice medicine, no Dr accountability, etc, etc. Only thing is I reported I was feeling much better b4 he left, I never got the chance to let him tell me MDone accrues interest making the worst credit cards taste like cake when you have something go wrong like, loss of pills, change of dr and his beliefs are different so he lowers ur dose…Anyway, the worst scenario next to death occurred 1st in 2007 then again in 09, I was hospitalised because what the v.a. dr. i was assigned to wasn’t familiar how to titrate a patient on methadone, the PDR,(the big blue book that guides Dr’s on meds and dosing), to my recollection has only been brought up in a conversation with a el paso P.A., and little did he know I knew what the PDR said about MDone word for word and he tried to lie to get me out of his office.What was happening is that my body at the time was dosed only 45mg daily causing my body to go into pain wrenching withdrawals, it changed my persona, my very being was turned upside down, I ended up getting arrested for driving my POV, I was withdrawaling in terrible pain. Later, the good Lord must have said enough, he lead me to a poor v.a. dr who had just gotten fired, but he saved my life, he raised my dose to 120 from 60mg, Jess, life changed inside of 1 hr. Pray Jess, let his Holy Spirit lead you, this next part is most important. I was supposedly cut off because the FDA has made changes targeting MDone patients, doesn’t matter if you have a spine that is failling apart like mine or whatever, the Lord is always in control!. He knew what was going to happen, thru means I attribute to the good Lord I had my initial pain management apptmnt in NM , se corner. She not only gave me an alternative to start coming down on MDone, called CDB or CBD, I’m dislexic, It has hemp extract in it. Ask a knowing Dr about this substance and its ability to start lowering your MDone dose, your brother in Christ…. E.D. If you have great results and wanna tell me bout them you must download Krypto on your Android cell, it’s ez to learn and use ok? Now you send it to this #5754993982 after your msg is encrypted, I think you can see why the need for this. Thank YOu.

Hi there I was in a similar situation as yourself regarding the effects methadone can have on our body’s. I was on an opiate for back issues when I took the wrong advice from my treating physician and switched to methadone . In Dec 2014 I was driving home and I passed out behind the wheel,why, undiagnosed prolonged QT. I was on 190 my for almost 3 years and my meth doctor cared less about me and kept me at that leveleven though my QT was in the low 500s I should have been 440-460 ,but he couldn’t care less,I since have started legal action against him,see if he cares now. Thankfully,with the approval of my new ,very caring methadone doctor of 2yrs and my family doctor,they are working with me to get my dosage down,now at 80mg,to a level where I can drop the meth for an opiate ,then transition to a very safe Suboxone. I take my meth daily in the morning and use the morphine for tapering and withdrawal which happens about 8 hrs after my drink each day. I have been on meth for 12 yes,and now I know I can beat this. I live in Canada,Toronto city,and I found a caring doctor. They are out there,just difficult to find,try asking your doctor to help you taper off by use of morphine,I have dropped110 mg in just over a year. Without the opiate,I never could have done this. It’s working,I take 100mg of morphinec4tines daily and taper off the meth biweekly by 1 to 2 my ,it’s working,I hope you find a doctor to help you. Good luck and try to keep dosage down to prevent torsaddes de poinntes from occuring due to prolonged QT.

Hey,
I wish you well with your lawsuit. The only things is, if you did ANY research on this medication (whenever a doctor puts me on ANY new med i always ALWAYS research it before being put on it so I know what to expect) you would have known the risks. Yes obviously the doctor should have told you but as adults we are capable of checking what we are putting in our bodies. Second, if you did any research you would have known that 190mg of methadone is VERY VERY high to be on. I am on 30mg and have no plans on going much higher. Plus with the new gov laws, most patients will start being restricted to no more than 40mg or so. So as a suggestion, I think you should start reading about any meds you are planning on putting in your body. Good luck and God bless

P.s I can’t really understand one of your lines but I really hope you didn’t say you were taking 100mg of morphine 4 times a day along with 80mg of methadone. Do you mean you were taking it separately? If so that’s fine but if you were taking them together then that was putting you at a huge huge risk for od. If you check the opiates today and find out which one causes the highest risk of overdose (not talking about street drugs like fentanyl mixed with heroin) but prescriptions then morphine is number 1.

JESSICA, I know that this was posted months ago… But I was so moved by your POST…
You’re a brave young! To go through a lot and take care of a baby and deal with an addiction that was caused by a doctor and then them refusing to give you any help you’re amazing.

Thank you for this information. I would love to have my primary speak with you because I began taking Methadone for chronic pain from Degenerative Disk Disease and Fibromyalgia. At the time I was prescribed it in 2002 I was given Methadone 10mg every 4 hours plus Hydromorphone 8mg to take every as needed for breakthrough. I eventually asked them to lower and then stop prescribing the Hydromorphone since I was doing well with just the Methadone. I even began having the dosage of that lowered until it was handling my severe pain without any drugged feelings. For the last several years I have taken half of a 10mg Methadone four times per day. I still have pain on the dosage, but it is not bad enough to want to take more medication. I have successfully taken Methadone since 2002.

With all the changes to health care I am now being told I can no longer be prescribed the only medication which stops my pain without making me feel high. My doctor even tried referring me to a pain clinic who wanted to stop giving me any Opiod medication and put me back on three medications I tried before taking Methadone. None of them did anything for my pain. I realize many people abuse Opiods, and I know we are all going to be punished for their misuse of the medications like Methadone. I am scared of facing the level of pain I had prior to finding relief. I would rather not take any medication, but it seems insane to stop prescribing what works for a trial of something which may not.

My doctor has said he will now prescribe me Morphine instead of Methadone, but he seems to think doing a switch of 2 Methadone 10mg pills daily for 2 ER Morphine 15mg pills will be great. I can say after two weeks of it that there is nothing great about it. I am now in bed almost constantly because I am in such pain that walking or standing for more than a few minutes has me in tears. This ER medication is not even remotely as long acting as the regular Methadone. If he prescribed the ER Morphine 15mg to take 3 times per day it might be better, but I will most likely still be taking several Tylenol or Ibuprophen each day with it.

I do not personally know of anyone who takes pain medication who asked for lower doses without being prompted by a doctor. I refuse any pain management when in the hospital, and I follow my pain agreements down to each requirement. I am tired of suffering for irresponsible people, but it doesn’t seem like there is an end to it with more celebrity overdoses each year. I read more comments calling for a ban on opiod medications with each passing day. If those individuals experienced even a full day of chronic pain it would be a wake up call.

I am now waiting to get in to see my doctor so he can prescribe the proper dosage to be as equivalent to the Methadone dose I was taking as possible. My question is what ways can I get more proactive in educating people or involved in campaigns for patient’s rights? I have seen a complete shift from when I first began taking Methadone in 2002 until this month when I was switched to Morphine. According to my doctor there are none in my area who are willing to prescribe Methadone because it is too dangerous and one pill can kill a person by stopping their breathing. I would suspect an individual who abuses the medication or mixes it with other substances would be more likely to have problems than someone, like myself, who does not drink alcohol or take over the counter medications beyond Tylenol or Ibuprophen. Had I been abusing the medication or taking more than prescribed I do not believe I would still be alive after so many years on it. I worry there will soon be laws making it more difficult to get pain relief, and if I can help speak out against such a thing I would like to know where to begin. Thank you for this site and the information!

Gemini, i too am a Gemini- we rock! – i am also on methadone for chronic pain. And i guess i get to be the first pereon you meet that also asked for a lower dossge. Last summer i asked my doctor to bring me down from 5 10mg tabs per day (2 at wake up, 2 at noon, 1 at night, if needed, which i found was rare) to 3 tabs per day. At first i tried taking 1omg three times but the relief was not sufficient for me to function. I just have to have 2 tabs to get to and through a hot shower. About 8 months ago he surprised me – by lowering me to 20mg per day! I admit i was terrified. However i am surviving, despite worsening issues with “bone spur” type formations on my cervical vertebrae he says are caused by arthritis and the source of the neuralgia in my feet and increased pain. I am getting by on those 2 tabs esch day. I take them both in the morning and only when i am in tears do i take an extra tab at night. Im scared to death of what hsppened with your doctor happening to me. I have heard the rumors about outlaawing methadone prescriptions etc and pray daily for this to be prevented at all costs bc it is the only medication that has any kind of effect on my pain. I have abused oxycodone 30s in the past and probably developed the tolersnce of a rhinocerous due to this, but methadone has literally saved my life bc i would have ended it myself if forced to spend another day without any relief. I tried to abstain from opioids for years, using an alphabet of NSAIDs, only to develop a perforated ulcer that nearly took me out. After a month in the hospital on a pain pump I met my pain management specialist and agreed to try methadone. After 18 months of what was for me an insane difference in ability to function and do things like cook or clean and wash my own laundry, it dawned on me that i had no other options left should i become tolerant to the methadone as i had every other opioid on the market. I am just 37 years old and been on opioids since i was 19 – id like to think ive got a few decades left and my neck isnt getting better its getting worse fast – i wanted to take steps to prolong the effectiveness of this medicine for myself since i truly cant imagine life without it. And believe it or not, i take a benzo too. 2mg of klonopin daily is what im prescribed for anxiety and ptsd but i usually just take one. But when i am in a stressful environment i do use both klonopin and i have not died or felt like i would die and i cant not take it either. I have heard that the risk of the stopping breathing thing is higher with xanax for whatever reason. I used to be prescribed xanax with oxycodone and i prefer the klonopin it has less of a droopiness factor than xanax. May i ask where you live? My heart goes out to you i can truly understand the distress you must be going through and will keep you in my prayers bc you make a valid point that punishing everyone for the actions of few is not the answer to the prescription drug abuse problem. I dont pretend to know what the solution might be but taking an effective, affordable, and safe treatment medication from patients in dire need is definitely not it. I hope your doctor can get you back on your feet. If not, ill gladly refer you to mine!

OMG , we are so much alike. I took eleven 10mg methadone pills for over 14 years due to a failed disk surgery which because all of my disks had been smashed, and I have absolutely no clue how this happened, I, too, was bluntly told my methadone was being cut to four 10mg pills a day. Now common sense will tell you to go from 11 pills a day to 4 pills a day is something I wouldn’t do to my dog. My pain is not chronic; it is ONGOING, which makes a huge difference when trying to figure out the right dose for me. Plus I am beyond upset that our government, who already has made our life miserable, thinks they have ALL the knowledge needed to issue this order when they do NOT know my story; that there are greedy doctors who will prescribe everyone anything to make money; and the fact I, too, went through total misery when this edict first came out. I just couldn’t believe the government was sticking their nose into something that takes a doctor years and years to learn, and even then some of these so-called doctors don’t have the common sense they were born with either. As one WISE doctor put it, a pain patient needs their pain medications just as a diabetic needs their insulin. I also informed my doctor I’d rather die than spend the rest of my life in total misery because some know-it-all bureaucrat decided they knew more about this latest “crisis” than most doctors do. I feel like we’re not living in a dictatorship anymore. When the government can tell you that you no longer can take the one and only medicine that ever worked for you, there is something dreadfully wrong with this kind of thinking. There needs to be a limit as to what the government can interfere with, and this is definitely one of them, to start telling doctors what they can and cannot prescribe for their patients. You can’t tell me that a lot of these deaths were pretty much self inflicted as in someone trying to get as high as they could and only used their “pain pills” for entertainment, NOT because they truly had acute and chronic, and in my case, ongoing neck, shoulder, back and now arm pain as I waited too long to go see a doctor as I’m far from being a hypochondriac; I dread going to the doctor but in my case, I was followed closely, incessant and constant doctor’s visits; blood work to ensure my pain regimen wasn’t affecting my organs…. almost FIFTEEN YEARS of this, and they actually think I like doing this ……. NOT!!!

I was tried on everything but nothing worked, OxyContin, oxycodone, and hydrocodone which I just recently told my doctor there was no use in taking them as they simply didn’t work anymore. I will never get over this as in my humble opinion they delved into a part of people’s lives they had no business getting involved with, as my doctor knows me well enough that she knows I have TRUE PAIN, so bad that I really don’t have much of a life anymore as even when I was on the methadone, pain takes something out of you.

At the end of the day, I’m so exhausted from trying to maintain some kind of normalcy in my house, plus doing any kind of work when you’re in pain, again, common sense wise, will tell you fighting pain and trying to live as normally as possible is getting to the point I won’t be able to do much house work, a dab of cooking, etc., soon, unless they can figure something out for me as just being in pain makes you tired and to then try to do much of anything else is going to be impossible for me in the very near future. Well, I could go on forever, but I truly feel what has transpired was an inhumane act that everyone is choosing to ignore as when you’re NOT in pain, it’s hard to understand and/or empathize. The older they get these so-called experts that started all this will no doubt be in pain, and I hope they are, not to be mean but to show them how utterly ignorant they were and what they did to thousands of innocent people thanks to their ignorance and not taking enough time to research this issue. I have no doubt a lot of these deaths were caused by methadone, but as long as I’ve been taking methadone and am almost 70, I’d much prefer taking my chances with methadone and living relatively pain free versus living in terrible, wracking, vicious, pain that is so severe, you lose your appetite and in all honesty have nothing to live for. I’m sure even my family wouldn’t want me spending my last days like this, but I will because I love them too much and couldn’t hurt them by choosing to leave this earth on my own.

Dear Corinne ,, You and I are in the same boat and almost with identical problems and the same age (or close). 69 yrs old. The government created this problem and now that it is out of control, they don’t know what to do other than blame it on the innocents who are suffering. It isn’t a nice thing to wish on anyone, but I to, wish the same fate on the beurocrats who caused this.

Last week I ran out of Norco 10/325. I had 4 days to go before my doctor appt. Rather than deal with the extreme pain and withdrawal, a friend offered me some methadone. It did help the pain and no withdrawal. When I got in to see the doctor, he randomly drug tested me. Of course the methadone came up on the drug screen. Now he will not prescribe anything. Not even my muscle relaxants. Because of these insane laws,, I am forced to stay on the methadone and will probably have to go to a methadone clinic. What a crime to put a senior through this. I have had MRI, EMG, xRays, etc etc. All tests showed impairment of the cervical and lumbar nerves, Stage 4 osteoarthritis, degenerative disc disease, cervical and lumbar radiculopathy,. I also have had thyroid cancer and other physical problems that are all documented by test results.

I guess, I just want you to know, that you are not the only senior out there that is being persecuted by our government.sticking its nose where it doesn’t belong.

I have talked to men who have returned from the Middle East fighting for our country. I’m told the VA gave hydrocodone to ANYONE who was in active combat there, injured or not.

Go to another doctor. I would try the honesty is the best policy, however, do not state you received the methadone from a friend as they could be in trouble criminally for giving you their pills. That is how overdoses happen and why the laws are getting more strict. It really is to protect the majority and prevent anyone from having “extra” pills that they could give to a friend. I realize it was to try to help you, but, it is still very dangerous
Good luck finding another doctor or pin management clinic.

You are so right. Methadone is the best pain medication I have ever taken. With it being the best at treating my pain, he has decided to take me off of it all at once and put me on Morphine. By the way I have taken this for 6 yrs. I have Lupus, Fibromyalgia, degenerative disk disease, etc. Morphine doesn’t help me at all. I was allergic to it. So know I’m waiting to see just what he will treat my pain with now??

I have the same conditions as you. I was forced to a methadone clinic and am on 9o mg of methadone . As car accident made my sciatica nerve pain a constant 8 and a 10 4-6 times a day. So I was given oxycodone 20mg fir that with my methadone, but that is not enough to be effective. I was on Klonopin 4mg a day and the clinic forced me to stop taking it out my PTSD and anxiety are back

Sorry pushed wrong button last time, I am a 38 year old carpenter and was a commercial fisherman and have 8 fusions and a femur implant. Have been prescribed 60 mg hcl methadone for over 5 years and since I typically work out of state in places like North Dakota and I live in Idaho it is increasingly difficult to. Not run out of my medication and regularly taper myself as bot to run out. As I am sole provider of income in my family I regularly contemplate “kicking” but my pain levels restrict my activity not to mention I don’t have months to lay around and be miserable. I read about a medication developed in Australia that supposedly blocks out those receptors or something. Is there any hope of life with out dependence for me?

I have had chronic lumbar / leg pain since 2000. Herniated discs and degenerative disc disease. TRIED on Methadone after Fentanyl to costly. Titrated to eventually 80mg/day with Percocet.I Started with new pain management .Pain increased finally and she added Fentanyl*(got up to 100 mcg).I went to surgeon and he thought Fusion L4-S1 was answer. Did not fuse. Pain high. And got upvto Fentanyl 225mcgs with same Methadone and Norco. 2nd. Fusion worked but had post-lamenectom syndrome , failed back surgery. Put in spinal cord stimulator; no help with back. Pain management changed meds to oxycontin,ER 60 mg, Methadone same and oxycodone, . Got Intrathecal pump with morphine. New pain management doctors started at approx 2mg. Withdrawal from Methadone for 2 months. He would not taper. Added Fentanyl to morphine in pump and got to 9mg/ 137mcg of Fentanyl. Pain still high and 2nd dye test ordered. I had Methadone at home and finally took some. He released me and that was my first and only bad urine in 8yrs.Beg. of end of pump.Got the only other pain Dr. For the pump in 50:mile radius Changed to Dilaudid, got up to 6 mg. Less help and Dr. Moved away abruptly. To make it short, unhappy no dr. With experience left. Developed spasms and put on Baclofenand aalso had Oxycodone 15:mg for rescue. Got hunched back in the 1 yr and 5months w/pump. Those Drs. Were horrible and Released me for a nontherapeutic relationship! Saw new Dr one time. well I just had pump and stimulator removed 3 days ago.The PROBLEM-my oral pain Dr. Of 6 yrs won’t take me back. I am in withdrawal because surgeon but on 75 fentanyl patch plus 5 mg of oxycodone short acting, take 3 every 6 hrs. H e said 60 tab. Would have to last 12 days. I can’t sleep, no appetite. Etc.In pain and sick! Have appt with a pain dr in 3days. BUt I hear he isn’t a med doctor.Help what do I do? Have anther backup pain dr in 2weeks . I am home bound and scared and in PAIN! HELP

I don’t know if you can help with a question. Living in Fl it’s been very difficult to get methadone prescriptions filed. My husband was on 10 mg 1 tab 4 times daily with morphine Ir 15mg 1tid. He cannot get methadone filled. His pm Dr switched him to morphine 15mg ER 1tid. No meds for methadone detox like clonidine. He’s miserable. He can’t sleep or work. Looking at your chart the morphine dose equal to 40mg of methadone daily is way higher. We need to talk to his Dr but, do not know what dose of morphine would be equivocal to methadone. Can you help with a suggestion. Or can this chart help. I see it’s morphine to methadone.

Thank you so much. His appointment is today. I have found a number from Albany. I hope it is correct. He was never brought back in for a month for increase as the half life of methadone was dropped. He has been a pt at this office for over 2 yrs and has never had a med increase or methadone level checked. New Drs. Just took over the practice. I don’t think people realize that even when being switched to another opiate you still detox from methadone. I went thru this has a could not get my meds at any pharmacy either. The treatment from most pharmacies here is bad. Most won’t even carry methadone and it is such a wonderful medication for pain. Yet so miserable when you can’t get your meds and have to be changed. I am so grateful to see a Dr. that actually gets it. I wish you were in Florida. I will offer your information to the office.

I live in Florida and I have had a terrible time being on methadone and other pain management drugs such as morphine, dilaudid etc. I have been taking methadone for about 15 years. I have neck, back and hip problems basically to simplify things. At the point of my highest methadone dosage I was taking 20 to 21 ten mg morphine pills plus morphine or dilaudid or oxycodone or oxycotin for breakthrough pain. During this time I fell and broke my hip and have had 2 hip surgeries and need another. I changed drs and the new dr took me from 5 ten mg pills to 3 n a dose. Then that was working okay and the government stepped in here in Fl and made some law that you can only get 120 pills of methadone or other similar drugs a month. That took me from it was either 320 -360 pills a month to 120 all of a sudden. Its like in Jan I was taking the 300 some 10 mg pills a month and in Feb I got 120. The pharmacist said she was concerned and she called my dr and he said I could have the regular dose of the 300 some pills but the pharmacies wont fill them anywhere. Only 120. That gives me 3 ten mg methadone plls a day. I have the morphine for breakthrough pain 1 30 mg pill every 6 hours. Needless to say I feel terrible and I wonder how long its going to take me to adjust to this new dosage.

is there a way to take my last name off here? I thought it was required and after posting I see no one else has. Thank you. Can u also tell me if you are taking 3 ten mg methadone pills a day how you can wean off them? Because of the difficulty in getting these pills here in Fl I am scared of not being able to get them-( I had one dr close his office without any warning, etc) and having to go thru withdrawals. If you wean off of them by reducing your dosage how do you do that without replacing it with suboxone or some other such drug. I have been thru heroin withdrawals before and they say methadone is worse.

Thank you so much. You could have left my first name though. Do you have any comment about what I wrote? thanks, this is a great forum. I am having alful restless legs and just feel like I want to get out of my skin That has to be the most uncomfortable feeling, the pain is more tolerable than that to me. I know they say hot baths etc to help rid yourself of the muscle aches. any other recommendations that are different than all the usual ones people give like exercise etc.

Without knowing your medical background I can’t really make a recommendation. Aside from that, I am unable to give medical advice on this forum but I am okay with communicating with your doctor if he/she contacts me.

I am also looking at having hip surgery in the coming six months probably, and they also want me to have neck and back surgery. I have had two hip operations, and I have one of those defective hips in me now that they were putting out around 2006 when I had mine done. I don’t like suing- I believe most doctors are doing the best they can, n the case of the hip I didn’t want to sue either, and then years later when I realized it WAS going to affect the quality of my life for the worse forever I decided to sue the manufacturer and was told I was 3 years too late to do that. I am going to have the hip surgery, but not the neck and back surgery I don’t think- I am so scared after what they did to my hip in those 2 operations. I DIDNT THINK I WOULD EVER WALK AGAIN.. but God is a great healer and I can walk again, but my hip is so painful and so messed up and I keep falling because of the length difference of my legs and I am dragging my leg on that side and I know I cant put it off anymore. The neck surgery he wants to do first because he says if I fall or hit my neck a certain way I can become paralyzed and then I would never be able to have the neck surgery and fix it. I heard they have new developments in the hip replacements and that the recovery is quicker, do you know anything about that? Thanks so much for helping all of us. You are a wonderful person!!

ok thank you. my concern is that if I am taking 120 10 mg methadone and 120 30 mg morphine a month now- and that is all the pharmacies here in Fl can legally fill…..if I go and have the hip surgery I already am up to the most allowed dosage and wont be able to get anymore than what I am taking now. I know the pain of the hip replacement- it is terrible and I think I will have REALLY bad pan after the operation and the quantity of pills I will be able to get is no more than I have now- which is really not enough for me. I was doing a lot better on the higher amount of about 360 a month- I was taking 3 of the 10 mg methadone in each dose so I could get some things done- I am on disability and cant work- but one 10 mg methadone pill every 6 hours really doesn’t do much of anything at all. I have the 30 mg morphine also and I try not to take too much anri inflammatory pills, he had me on Meloxicam and then took me off it saying it wasn’t good for anyones stomach- which I pretty much know the danger of damaging your stomach from those type of pills. So if you are fine talking with him I will work on setting the surgery up and then have hi contact you for your opinion or whatever- he is a great doctor his name is Dr Maulk K Bhalani here in Zephyrhills and Wesley Chapel Fl. I would highly recommend him to people here in the area looking for pain management dctors. I hate taking all that pain medication and he got me down from what I was taking which was almost at the line of being a lethal dosage. Thank you again. He has also recommended putting some sort of device in my side or something but that sounds downright scarey to me.

I’m very appreciative of the empirical formula to suggest likely methadone doses derived from morphine doses. The selection of an appropriate methadone dose truly is an art – no algorithm can show, of course, that a patient’s dose is “wrong” – it’s very much dependent on independent symptomatology. But the conversion calculation does help get a target for estimating doses.
I’m interested in:
#1) Where did the data come from for curve-fitting?
#2) Did this come from fitting a taylor series to the data?

Hi Dr. Vaughn. Both are very good questions indeed! The data came from “curve-fitting” in that I took the three studied (perhaps most utilized) schematics by Doctors Ripamonti(1998), Ayonrinde(2000), and Mercadente(2001). All of them are problematic in that they have severe peaks and troughs at 3 and 5 break points. As such, my son (an engineering student at the time) and I developed a formula (by trial and error) in order to fit the most conservative points at the bottom of the curve while at the same time smoothing it out to eliminate the peaks and troughs. As it turns out, unbeknownst to us at the time, the method squarely matches the Fournier Series of combined simple sine waves. If you have not read it, I suggest you see [Fudin J, Marcoux MD, Fudin JA. Mathematical Model For Methadone Conversion Examined. Practical Pain Management. Sept. 2012. 46-51.], which clearly outlines the reasons we did this and compares the “Fudin factor” against the other schematics in great detail. I hope this answers your questions adequately.

I suffer from chronic pain since 2009 and had a cervical fusion after nothing else working to releive the pain. I have been thru many pain meds in the last four years and am tired of all of them. At this point my doctor has changed me morphine sulfate 30 mg to methadone 5 mg and the first month went well but still felt the pain so she gave me oxy for breakthru pain. The second month I felt that I was taking more oxy bc of the pain so I started taking a pill and a half, like 7 mgs every 12 hours and now Im feeling very faint and dizzy but the pain is still the same. Im worried bc I do not want to increase the medication I rather stop the methadone and go back to my old meds the morphine and oxys. I stopped them bc the pain is getting worst and I dont want to increase my meds. I have been diligent and am at 15 mg of oxycodone and 30 mgs of morhine since 2010.
I need to know how I can stop the methadone and go back to the morphine with oxycodone, please help.
CX

Ca ri;
Thank you for this comment. Unfortunately it is not safe or medically appropriate for me to give such advice on this sort of forum. I suggest you contact your doctor ASAP and discuss the situation with him or her. Also, it is nor wise to adjust any medication without the consent and advice of the prescribing practitioner. Good luck!

I’ve been on long term (~8yrs) pain management for spinal issues (5 neck/back surgeries, 3 additional ruptured disks, failed back syndrome, nerve damage) and severe generalized osteoarthritis. For the past 3yrs it has included methadone and a short-term narcotic w apap (pain level increases with activity level). I had to switch doctors a year ago due to insurance and he changed me from 45mg (15mg 3x day) and hydrocodone 30mg (10/325 3x day) to methadone 30mg and oxycodone 22.5mg (7.5/325 3x day) even though I had effective pain management. I figured initial increase in pain was possibly due to withdraw from the drop in methadone so I expected it to get better. After 2 weeks, this combination was only effective if I limited my daily activity level. So after 2 months he increased the oxycodone to 30mg (10/325 3x day)…. So, basically dropped the methadone from 45 to 30mg and switched hydrocodone to oxycodone in same dose. I’ve been on this for over a year now and its workable but not as predictable with certain activities (example: severe pain down my leg was mainly realized if sitting over an 1-2 hrs but now I get it for no apparent reason). Based on your calculators and experience I have 3 questions:
1 – In your opinion, what would be his rationale for the initial switch from hydrocodone to oxycodone? I thought thought being on hydrocodone was preferable to oxycodone both in perception and regulatory classing. Acetomenophine level is the same.
2 – The oxy provided adequate pain relief at 7.5mg but didn’t last long enough as pain level increases significantly with certain activities. I found myself quite uncomfortable at bedtime with half the daily activity as when on hydrocodone (which makes sense given the half-life change)? I was surprised when he went to 10/325mg 3x day instead of 7.5/325mg 4x day. Acetophemine level I wouldn’t think would be an issue since I was on the same level before.
I’m in small town Ohio and I there are only 2 pain doctors within a 3hr drive or I would change as be doesn’t seem to want to work with me but just prescribes what he thinks with no explanation.

I have a BS in chemistry but no experience/education in pharmacology or biological mechanisms.

Thank you for providing us all with this very informative site! I am located in the Royal Palm Beach area and would appreciate any information on where to seek help pertaining to Pain managements issues in this area.

I am a registered nurse and chronic pain patient. I am converting to methadone and would like to see if your calculated rate would be smoother than the one I am on. I am also taking tegretol for trigeminal neuralgia, which complicates dosing. Is there a way to use the calculator you offer without being an MD or pharmacist?
Thanks

Sarah,
Thank you for your interest in our online calculator. The reasons we require registration to convert to or from methadone are because of the inherent dangers of converting. Specifically, we don’t want to encourage inexperienced clinicians to place patients on methadone if they are not familiar with all of the dangerous variables when making the switch. I will paste the dialogue below that prescribers are required to check off prior to being allowed access.

You are also quite correct that Tegretol makes your situation even more complicated. Tegretol can significantly reduce serum methadone level, but abruptly stopping Tegretol while on methadone could elevate the levels so significantly that it could cause death.
My suggestion is that you share the online opioid calculator with your doctor and do the calculation with him/her. If you are anticipated to respond well to methadone due to its NMDA blockade properties, another viable option is levorphanol. Another option is to change Tegretol (carbamazepine) to a similar anticonvulsant that doesn’t affect methadone levels, such as Trileptal (oxcarbazepine) or another that is completely different.

All of these complex therapeutic issues require a skilled pain clinician. These are precisely the reasons we are careful with allowing non-experienced prescribers the latitude for a simple conversion without carefully considering all of these factors. As promised, see below…

Occupation » Questions
1. I recognize that methadone represented less than 5% of the total number of opioid prescriptions between 2002 and 2008, but was implicated in approximately 33% of opioid-related deaths. *
yes
no
2. I have received extensive training in prescribing methadone. *
yes
no
3. I am experienced as a clinician at prescribing methadone and monitoring patients on methadone. *
yes
no
4. I have read, understood, and adhere to the FDA’s Drug Safety Information regarding the prescription of methadone. FDA Drug Safety – Methadone *
yes
no
5. I recognize that methadone has complex pharmacokinetics, genetic polymorphism and inter-patient variability and must be titrated slowly. *
yes
no
6. I recognize that combining methadone with other opioids or sedatives can increase the risk of respiratory depression and cardiac arrest, which can lead to death *
yes
no
7. I understand that methadone has multiple drug interactions, and this should be reconciled for each individual patient. *
yes
no
8. I am aware that methadone in high doses has the propensity to prolong the Q-Tc interval. *
yes
no
9. I am aware that methadone is not routinely used for the treatment of acute pain. *
yes
no
10. I am aware that the methadone conversion and starting dose results provided by this calculator must only be used as one of multiple reference points in the prescribing process, and that multiple other patient-specific factors must be taken into consideration before determining the prescription dosage. I recognize that patients taking methadone must receive expert and ongoing monitoring. *
yes
no

Occupation » Questions
1. I recognize that methadone represented less than 5% of the total number of opioid prescriptions between 2002 and 2008, but was implicated in approximately 33% of opioid-related deaths. *
yes
no
2. I have received extensive training in prescribing methadone. *
yes
no
3. I am experienced as a clinician at prescribing methadone and monitoring patients on methadone. *
yes
no
4. I have read, understood, and adhere to the FDA’s Drug Safety Information regarding the prescription of methadone. FDA Drug Safety – Methadone *
yes
no
5. I recognize that methadone has complex pharmacokinetics, genetic polymorphism and inter-patient variability and must be titrated slowly. *
yes
no
6. I recognize that combining methadone with other opioids or sedatives can increase the risk of respiratory depression and cardiac arrest, which can lead to death *
yes
no
7. I understand that methadone has multiple drug interactions, and this should be reconciled for each individual patient. *
yes
no
8. I am aware that methadone in high doses has the propensity to prolong the Q-Tc interval. *
yes
no
9. I am aware that methadone is not routinely used for the treatment of acute pain. *
yes
no
10. I am aware that the methadone conversion and starting dose results provided by this calculator must only be used as one of multiple reference points in the prescribing process, and that multiple other patient-specific factors must be taken into consideration before determining the prescription dosage. I recognize that patients taking methadone must receive expert and ongoing monitoring. *
yes
no

Looks like no one helped you with your question regarding methadone dose conversion either. Maybe try talking like a P.hD who’s covering his ass and doesn’t want to approach anything that talks about your personal struggles that helped lead you to be on methadone today. That opens him to liability and also he might feel bad. You and I feel and live it everyday so we shouldn’t force people to read about what might cause people to be on this drug they wrote for monthson. I hope you recover well and get some medical advice too! Cause you wont get it here apparently.

Thank you for your work on this mystifying topic. I am a palliative care physician and have inherited a patient who had been on a hydromorphone PCA with a basal rate of 100 mg (!!!) per hour. She now has an intrathecal pump in place with great results and I am working to decrease her hydromorphone PCA, avoid withdrawal, and get her on a regimen thatworks with her surprisingly active life. Enter my desire to employ methadone.
This is approximately 40,000 mg of oral morphine a day – well beyond what your chart covers.
What are your thoughts on methadone conversion in these very high doses?
I know this patient’s conversion will be a process, but am curious about your thoughts.
Thanks for your time!
Emily Riegel

Hi I’m on 15ml of methadone and wed like to know the conversation to mst and or Dihydtocodiene. Which is best to detox from. What dosage n he many times aday. Wed b appreciated 4 advice as want of method as only 3mnth on it. I was clean for 10yr until my dad died in my arms last year and I relapsed 4 about 3mnth n nw IV bin on method 4 3mnth I just want of it and looking 4 advice plz. Ally. Allybhoyaliveandkickin666@Gmail.com.

Methadone is a very good drug. For chronic pain and for replacement therapy or maintenance. Methadone was developed in Germany during world war 2 to have an inside source of pain management similar to morphine. hydromorphone, oxymorphone, meperidine, or morphine, heroin, no matter opiates or opioids. Methadone does a few things very well. It works best being orally consumed. It has a super long half life and takes a few days to a week to build up in the system and then several weeks to get a maintenance dose adjusted to be safe while doing it. Methadone is stronger then morphine and heroin but takes longer to get the relief your looking for. The best part is you only have to use methadone once daily when using it for maintenance to reduce heroin craving, but still needs to be dosed generally 3-4 times daily for pain control. When switching to methadone from the hydromorphone you would reduce the hydromorphone and slowly introduce the methadone. Beginning at 30mg liquid dose and 24hours later increase methadone to 40mg. But decrease hydromorphone dramatically to prevent overdose and remember when giving methadone for withdraws and pain management and replacement therapy or maintenance. Methadone takes several days to one week for half life of the meds to build so it will be very touchy switching this patient but well worth it in my opion

Dr. Fudin once again knocks it out of the park! Having done an APPE with the “Fudin Factor” himself, it was very apparent what a great option methadone was for many patients with a neuropathic component to their chronic pain. It is unfortunate that there are many barriers to implementing its use in pain management such as negative social stigma (from experience- can be extremely challenging, especially in the VA setting) and a lack of prescriber education as to proper titration and conversion, since the kinetics of the drug itself present a challenge. Having a formula that prescribers can rely on to SAFELY convert methadone dosages is a great tool to allow prescribers to be more comfortable prescribing this. Certainly a step in the right direction to allow physicians to have methadone back in their pain management armamentarium.

This is the best I’ve seen converting methadone.
Methadone is a very different pain medication.
Nothing else works like methadone and in a way it makes methadone really special in its own way for severe chronic pain.
Seems no matter how much a person takes if you have been on it a while it works the same.

I wish I had a doctor that could or would understand how methadone reacts to pain and the patient. It does help pain effectively but it takes understanding on the tiltration. Thanks Dr Fudin for your excellent conversion table.

The article entitled ‘Methadone Dose Conversion Unscrambled’ is concise, logical and informative. The formula presented by Fudin, in my opinion, is the most accurate for predicting the target dose of methadone (after careful titration).